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Risk of childhood trauma exposure and severity of bipolar disorder in Colombia

Published online by Cambridge University Press:  19 July 2023

F. Guillen*
Affiliation:
1School of Medicine, Universidad Simon Bolivar
J. F. Galvez-Florez
Affiliation:
2Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
*
*Corresponding author.

Abstract

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Introduction

Bipolar disorder (BD) is higher in developing countries. Childhood trauma exposure is a common environmental risk factor in Colombia and might be associated with a more severe course of bipolar disorder in Low-Middle Income-Countries. We carried out the first case-control study (114 BD patients and 191 controls) in Colombia using a structural clinical interview and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to describe the prevalence and association between trauma exposure during childhood with a severe course of illness in a sample of BD patients.

Objectives

to describe the prevalence and association between trauma exposure during childhood with a severe course of illness in a sample of BD patients.

Methods

A case-control study (114 controls versus 191 controls) that assessed outpatients between 18 and 65 years old, at a teaching hospital in Barranquilla, Colombia was carried-out. All participants were assessed with the SCID-5-CV, the Young Mania Rating Scale (YMRS), and the Bipolar Depression Rating Scale (BDRS). Additionally, exposure to childhood trauma was assessed using The Childhood Trauma Questionnaire-Short Form (CTQ-SF). The CTQ-SF is a brevity 28-item Likert-type, with a five-factor structure: emotional abuse EA, physical abuse PA, sexual abuse SA, physical neglect PN, and emotional neglect EN, self-administered instrument in order to assess multiple types of trauma during childhood.

We generate an outcome variable named severe bipolar disorder defined by course severe of bipolar disorder as the presence of any clinical indicator of severity, previously delimited by the research team (early-onset, rapid cycling, ideation or suicide attempt, or 3 or more hospitalizations per year). Also, we carried out bivariate and regression analyses with each clinical indicator of severity as an outcome.

Results

Cases included 61.4% BD type I and 38.6% BD type II. The median age was 31.5 years (IQR, 75-24) for BD patients and 31 years old (IQR, 38-24) for healthy controls. A higher prevalence of childhood trauma was evidenced in cases compared to controls.

Multivariate logistic regression model in severe bipolar disorder

Severe Bipolar Disorder
VariableBSEOR95% CIp valuep modelR2
Emotional Abuse0.830.362.301.753.03<0.001<0.0010.10
Physical Abuse1.070.432.921.545.53<0.001<0.001
Sexual Abuse1.610.445.044.735.36<0.001<0.001
Physical Neglect0.280.491.320.931.870.117<0.001
Emotional Neglect1.240.383.452.285.23<0.001<0.001

Conclusions

This is the first association study between childhood trauma exposure as a higher risk for a severe course of illness in BD patients in Colombian. Our findings highlight the importance of screening and evaluating childhood trauma exposure during the course of BD patients.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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