Impact of childhood abuse on the clinical course of bipolar disorder

Jessica L. Garno, Joseph F. Goldberg, Paul Michael Ramirez, Barry A. Ritzler

Research output: Contribution to journalArticlepeer-review

350 Scopus citations


Background: Few investigations have examined the impact of childhood trauma, and domains of childhood abuse, on outcome in bipolar disorder. Aims: To evaluate the prevalence and subtypes of childhood abuse reported by adult patients with bipolar disorder and relationship to clinical outcome. Method: Prevalence rates of childhood abuse were retrospectively assessed and examined relative to illness complexity in a sample of 100 patients at an academic specialty centre for the treatment of bipolar disorder. Results: Histories of severe childhood abuse were identified in about half of the sample and were associated with early age at illness onset. Abuse subcategories were strongly inter-related. Severe emotional abuse was significantly associated with lifetime substance misuse comorbidity and past-year rapid cycling. Logistic regression indicated a significant association between lifetime suicide attempts and severe childhood sexual abuse. Multiple forms of abuse showed a graded increase in risk for both suicide attempts and rapid cycling. Conclusions: Severe childhood trauma appears to have occurred in about half of patients with bipolar disorder, and may lead to more complex psychopathological manifestations.

Original languageEnglish
Pages (from-to)121-125
Number of pages5
JournalBritish Journal of Psychiatry
Issue numberFEB.
StatePublished - Feb 2005
Externally publishedYes


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