TY - JOUR
T1 - Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder
AU - Post, Robert M.
AU - Altshuler, Lori L.
AU - Leverich, Gabriele S.
AU - Frye, Mark A.
AU - Suppes, Trisha
AU - McElroy, Susan L.
AU - Keck, Paul E.
AU - Nolen, Willem A.
AU - Kupka, Ralph W.
AU - Grunze, Heinz
AU - Rowe, Mike
N1 - Funding Information:
Dr. Nolen acknowledges receiving grants from The Netherlands Organization for Health Research and Development, the European Union, the Stanley Medical Research Institute, Astra Zeneca, Eli Lilly, GlaxoSmithKline and Wyeth; has received honoraria/speaker’s fees from Astra Zeneca, Lundbeck, Pfizer and Wyeth; and has served in advisory boards for Astra Zeneca.
Funding Information:
Dr. Suppes declares sources of funding of medications for clinical grants from the National Institute of Mental Health, Pfizer, Inc., AstraZeneca, and Sunovion Pharmaceuticals, Inc; and royalties from Jones and Bartlett (formerly Compact Clinicals).
Funding Information:
Dr. Frye acknowledges grant support from Pfizer, Myriad, National Alliance for Schizophrenia and Depression (NARSAD), National Institute of Mental Health (NIMH), National Institute of Alcohol Abuse and Alcoholism (NIAAA), and the Mayo Foundation.
PY - 2013/5
Y1 - 2013/5
N2 - Objective: A role for childhood adversity in the development of numerous medical conditions in adults has been described in the general population, but has not been examined in patients with bipolar disorder who have multiple medical comorbidities which contribute to their premature mortality. Methods: More than 900 outpatients (average age 41) with bipolar disorder completed questionnaires that included information about the occurrence of verbal, physical, or sexual abuse in childhood and whether their parents had a mood or substance abuse disorder, or a history of suicidality. These factors were combined to form a total childhood adversity score, which was then related to one or more of 30 medical conditions patients rated as present or absent. Results: The child adversity score was significantly related to the total number of medical comorbidities a patient had (p<.001), as well as to 11 specific medical conditions that could be modeled in a logistic regression (p<.03). These included: asthma, arthritis, allergies, chronic fatigue syndrome, chronic menstrual irregularities, fibromyalgia, head injury (without loss of consciousness), hypertension, hypotension, irritable bowel syndrome, and migraine headaches. Limitations: The contribution of parental diagnosis to childhood adversity is highly inferential. Conclusions: These data link childhood adversity to the later occurrence of multiple medical conditions in adult outpatients with bipolar disorder. Recognition of these relationships and early treatment intervention may help avert a more severe course of not only bipolar disorder but also of its prominent medical comorbidities and their combined adverse effects on patients'health, wellbeing, and longevity.
AB - Objective: A role for childhood adversity in the development of numerous medical conditions in adults has been described in the general population, but has not been examined in patients with bipolar disorder who have multiple medical comorbidities which contribute to their premature mortality. Methods: More than 900 outpatients (average age 41) with bipolar disorder completed questionnaires that included information about the occurrence of verbal, physical, or sexual abuse in childhood and whether their parents had a mood or substance abuse disorder, or a history of suicidality. These factors were combined to form a total childhood adversity score, which was then related to one or more of 30 medical conditions patients rated as present or absent. Results: The child adversity score was significantly related to the total number of medical comorbidities a patient had (p<.001), as well as to 11 specific medical conditions that could be modeled in a logistic regression (p<.03). These included: asthma, arthritis, allergies, chronic fatigue syndrome, chronic menstrual irregularities, fibromyalgia, head injury (without loss of consciousness), hypertension, hypotension, irritable bowel syndrome, and migraine headaches. Limitations: The contribution of parental diagnosis to childhood adversity is highly inferential. Conclusions: These data link childhood adversity to the later occurrence of multiple medical conditions in adult outpatients with bipolar disorder. Recognition of these relationships and early treatment intervention may help avert a more severe course of not only bipolar disorder but also of its prominent medical comorbidities and their combined adverse effects on patients'health, wellbeing, and longevity.
KW - Affective disorders
KW - Childhood adversity
KW - Medical illness
KW - Obesity
KW - Physical and sexual abuse
KW - Psychosocial stress
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U2 - 10.1016/j.jad.2012.11.020
DO - 10.1016/j.jad.2012.11.020
M3 - Article
C2 - 23337654
AN - SCOPUS:84875366750
SN - 0165-0327
VL - 147
SP - 288
EP - 294
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-3
ER -