Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder

Robert M. Post, Lori L. Altshuler, Gabriele S. Leverich, Mark A. Frye, Trisha Suppes, Susan L. McElroy, Paul E. Keck, Willem A. Nolen, Ralph W. Kupka, Heinz Grunze, Mike Rowe

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)288-294
Number of pages7
JournalJournal of Affective Disorders
Issue number1-3
StatePublished - May 2013


  • Affective disorders
  • Childhood adversity
  • Medical illness
  • Obesity
  • Physical and sexual abuse
  • Psychosocial stress

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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