Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-26T08:20:16.635Z Has data issue: false hasContentIssue false

Childhood maltreatment contributes to the medical morbidity of individuals with bipolar disorders

Published online by Cambridge University Press:  26 April 2023

Ophélia Godin
Affiliation:
Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France Fondation FondaMental, Créteil, France
Marion Leboyer
Affiliation:
Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France Fondation FondaMental, Créteil, France Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMUIMPACT), AP-HP, Hôpitaux Universitaires Henri Mondor, FédérationHospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
Diane Grillault Laroche
Affiliation:
Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Paris, France Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
Valérie Aubin
Affiliation:
Fondation FondaMental, Créteil, France Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France
Raoul Belzeaux
Affiliation:
Fondation FondaMental, Créteil, France Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
Philippe Courtet
Affiliation:
Fondation FondaMental, Créteil, France Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
Caroline Dubertret
Affiliation:
Fondation FondaMental, Créteil, France AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
Sébastien Gard
Affiliation:
Fondation FondaMental, Créteil, France Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
Emmanuel Haffen
Affiliation:
Fondation FondaMental, Créteil, France Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
Emilie Olie
Affiliation:
Fondation FondaMental, Créteil, France Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
Mircea Polosan
Affiliation:
Fondation FondaMental, Créteil, France Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
Paul Roux
Affiliation:
Fondation FondaMental, Créteil, France Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'Adulte et d'Addictologie, Le Chesnay, France Equipe DisAP-PsyDev, CESP, Université Versailles Saint- Quentin-en-Yvelines - Paris-Saclay, Inserm, Villejuif, France
Ludovic Samalin
Affiliation:
Fondation FondaMental, Créteil, France Département de Psychiatrie, Centre Hospitalier et Universitaire, Clermont-Ferrand, France Université d'Auvergne, EA 7280, Clermont-Ferrand, France
Raymund Schwan
Affiliation:
Fondation FondaMental, Créteil, France Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
Frank Bellivier
Affiliation:
Fondation FondaMental, Créteil, France Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Paris, France Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
Bruno Etain*
Affiliation:
Fondation FondaMental, Créteil, France Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Paris, France Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD) Collaborators
Affiliation:
Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France
*
Corresponding author: Bruno Etain, E-mail: bruno.etain@inserm.fr

Abstract

Background

Individuals with bipolar disorders (BD) are at risk of premature death, mainly due to medical comorbidities. Childhood maltreatment might contribute to this medical morbidity, which remains underexplored in the literature.

Methods

We assessed 2891 outpatients with BD (according to DSM-IV criteria). Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Lifetime diagnoses for medical disorders were retrospectively assessed using a systematic interview and checked against medical notes. Medical morbidity was defined by the sum of medical disorders. We investigated associations between childhood maltreatment (neglect and abuse) and medical morbidity while adjusting for potential confounders.

Results

One quarter of individuals had no medical comorbidities, while almost half of them had at least two. Multivariable regression showed that childhood maltreatment (mainly abuse, but also sexual abuse) was associated with a higher medical morbidity. Medical morbidity was also associated with sex, age, body mass index, sleep disturbances, lifetime anxiety disorders and lifetime density of mood episodes. Childhood maltreatment was associated with an increased prevalence of four (i.e. migraine/headache, drug eruption, duodenal ulcer, and thyroid diseases) of the fifteen most frequent medical disorders, however with no difference in terms of age at onset.

Conclusions

This large cross-sectional study confirmed a high medical morbidity in BD and its association with childhood maltreatment. The assessment of childhood maltreatment in individuals with BD should be systematically included in routine care and the potential impact on physical health of psycho-social interventions targeting childhood maltreatment and its consequences should be evaluated.

Type
Original Article
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

List of FondaMental Advanced Center of Expertise (FACE-BD) collaborators:

References

Aas, M., Elvsashagen, T., Westlye, L. T., Kaufmann, T., Athanasiu, L., Djurovic, S., … Andreassen, O. A. (2019). Telomere length is associated with childhood trauma in patients with severe mental disorders. Translational Psychiatry, 9(1), 97. doi:10.1038/s41398-019-0432-7.CrossRefGoogle ScholarPubMed
Agnew-Blais, J., & Danese, A. (2016). Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: A systematic review and meta-analysis. The Lancet. Psychiatry, 3(4), 342349. doi:10.1016/S2215-0366(15)00544-1.CrossRefGoogle ScholarPubMed
Amare, A. T., Schubert, K. O., Klingler-Hoffmann, M., Cohen-Woods, S., & Baune, B. T. (2017). The genetic overlap between mood disorders and cardiometabolic diseases: A systematic review of genome wide and candidate gene studies. Translational Psychiatry, 7(1), e1007. doi:10.1038/tp.2016.261.CrossRefGoogle Scholar
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Andersen, P. K. (2017). Life years lost among patients with a given disease. Statistics in Medicine, 36(22), 35733582. doi:10.1002/sim.7357.CrossRefGoogle ScholarPubMed
Baumeister, D., Akhtar, R., Ciufolini, S., Pariante, C. M., & Mondelli, V. (2016). Childhood trauma and adulthood inflammation: A meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-alpha. Molecular Psychiatry, 21(5), 642649. doi:10.1038/mp.2015.67.CrossRefGoogle ScholarPubMed
Bernard, K., Frost, A., Bennett, C. B., & Lindhiem, O. (2017). Maltreatment and diurnal cortisol regulation: A meta-analysis. Psychoneuroendocrinology, 78, 5767. doi:10.1016/j.psyneuen.2017.01.005.CrossRefGoogle ScholarPubMed
Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., … Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse and Neglect, 27(2), 169190. doi:10.1016/s0145-2134(02)00541-0.CrossRefGoogle ScholarPubMed
Burdick, K. E., Millett, C. E., Yocum, A. K., Altimus, C. M., Andreassen, O. A., Aubin, V., … McInnis, M. G. (2022). Predictors of functional impairment in bipolar disorder: Results from 13 cohorts from seven countries by the global bipolar cohort collaborative. Bipolar Disorders, 24(7), 709719. doi:10.1111/bdi.13208.CrossRefGoogle ScholarPubMed
Buysse, D. J., Reynolds, C. F. 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193213. doi:10.1016/0165-1781(89)90047-4.CrossRefGoogle ScholarPubMed
Chan, J. K. N., Tong, C. H. Y., Wong, C. S. M., Chen, E. Y. H., & Chang, W. C. (2022). Life expectancy and years of potential life lost in bipolar disorder: Systematic review and meta-analysis. British Journal of Psychiatry, 221(3), 567576. doi:10.1192/bjp.2022.19.CrossRefGoogle ScholarPubMed
Chang, C. K., Hayes, R. D., Perera, G., Broadbent, M. T., Fernandes, A. C., Lee, W. E., … Stewart, R. (2011). Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS One, 6(5), e19590. doi:10.1371/journal.pone.0019590.CrossRefGoogle Scholar
Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., … Stubbs, B. (2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: A large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163180. doi:10.1002/wps.20420.CrossRefGoogle Scholar
Danese, A., & Tan, M. (2014). Childhood maltreatment and obesity: Systematic review and meta-analysis. Molecular Psychiatry, 19(5), 544554. doi:10.1038/mp.2013.54.CrossRefGoogle ScholarPubMed
D'Elia, A. T. D., Matsuzaka, C. T., Neto, J. B. B., Mello, M. F., Juruena, M. F., & Mello, A. F. (2018). Childhood sexual abuse and indicators of immune activity: A systematic review. Frontiers in Psychiatry, 9, 354. doi:10.3389/fpsyt.2018.00354.CrossRefGoogle ScholarPubMed
Etain, B., Aas, M., Andreassen, O. A., Lorentzen, S., Dieset, I., Gard, S., … Henry, C. (2013). Childhood trauma is associated with severe clinical characteristics of bipolar disorders. Journal of Clinical Psychiatry, 74(10), 991998. doi:10.4088/JCP.13m08353.CrossRefGoogle ScholarPubMed
First, M., Sptzer, R., Gibbon, M., & William, J. (1995). Structured clinical interview for DSM-IV axis I disorders—patient edition (SCID-I/P). New York: New York State Psychiatric Institute.Google Scholar
Godin, O., Gaube, G., Olie, E., Belzeaux, R., Bellivier, F., Loftus, J., … Etain, B. (2021). Childhood maltreatment and metabolic syndrome in bipolar disorders: In search of moderators. Psychoneuroendocrinology, 131, 105327. doi:10.1016/j.psyneuen.2021.105327.CrossRefGoogle ScholarPubMed
Grillault Laroche, D., Curis, E., Bellivier, F., Nepost, C., Courtin, C., Etain, B., & Marie-Claire, C. (2020). Childhood maltreatment and HPA axis gene expression in bipolar disorders: A gene network analysis. Psychoneuroendocrinology, 120, 104753. doi:10.1016/j.psyneuen.2020.104753.CrossRefGoogle ScholarPubMed
Grillault Laroche, D., Curis, E., Bellivier, F., Nepost, C., Gross, G., Etain, B., & Marie-Claire, C. (2021). Network of co-expressed circadian genes, childhood maltreatment and sleep quality in bipolar disorders. Chronobiology International, 38(7), 986993. doi:10.1080/07420528.2021.1903028.CrossRefGoogle ScholarPubMed
Grillault Laroche, D., Godin, O., Belzeaux, R., M'Bailara, K., Loftus, J., Courtet, P., … Etain, B. (2022 a). Association between childhood maltreatment and the clinical course of bipolar disorders: A survival analysis of mood recurrences. Acta Psychiatrica Scandinavica, 145(4), 373383. doi: 10.1111/acps.13401.CrossRefGoogle ScholarPubMed
Grillault Laroche, D., Godin, O., Dansou, Y., Belzeaux, R., Aouizerate, B., Burte, T., … Etain, B. (2022 b). Influence of childhood maltreatment on prevalence, onset, and persistence of psychiatric comorbidities and suicide attempts in bipolar disorders. European Psychiatry, 65(1), e15. doi:10.1192/j.eurpsy.2022.7.CrossRefGoogle ScholarPubMed
Hanssen, L. M., Schutte, N. S., Malouff, J. M., & Epel, E. S. (2017). The relationship between childhood psychosocial stressor level and telomere length: A meta-analysis. Health Psychology Research, 5(1), 6378. doi:10.4081/hpr.2017.6378.CrossRefGoogle ScholarPubMed
Hayes, J. F., Miles, J., Walters, K., King, M., & Osborn, D. P. (2015). A systematic review and meta-analysis of premature mortality in bipolar affective disorder. Acta Psychiatrica Scandinavica, 131(6), 417425. doi:10.1111/acps.12408.CrossRefGoogle ScholarPubMed
Henry, C., Godin, O., Courtet, P., Azorin, J. M., Gard, S., Bellivier, F., … Etain, B. (2017). Outcomes for bipolar patients assessed in the French expert center network: A 2-year follow-up observational study (FondaMental Advanced Centers of Expertise for Bipolar Disorder [FACE-BD]). Bipolar Disorders, 19(8), 651660. doi:10.1111/bdi.12539.CrossRefGoogle ScholarPubMed
Hosang, G. M., Fisher, H. L., Hodgson, K., Maughan, B., & Farmer, A. E. (2018). Childhood maltreatment and adult medical morbidity in mood disorders: Comparison of unipolar depression with bipolar disorder. British Journal of Psychiatry, 213(5), 645653. doi:10.1192/bjp.2018.178.CrossRefGoogle ScholarPubMed
Hosang, G. M., Fisher, H. L., Uher, R., Cohen-Woods, S., Maughan, B., McGuffin, P., & Farmer, A. E. (2017). Childhood maltreatment and the medical morbidity in bipolar disorder: A case-control study. International Journal of Bipolar Disorders, 5(1), 30. doi:10.1186/s40345-017-0099-z.CrossRefGoogle ScholarPubMed
Hosang, G. M., Manoli, A., Shakoor, S., Fisher, H. L., & Parker, C. (2023). Reliability and convergent validity of retrospective reports of childhood maltreatment by individuals with bipolar disorder. Psychiatry Research, 321, 115105. doi:10.1016/j.psychres.2023.115105.CrossRefGoogle ScholarPubMed
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., … Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. Lancet Public Health, 2(8), e356e366. doi:10.1016/S2468-2667(17)30118-4.CrossRefGoogle Scholar
Kessing, L. V., Ziersen, S. C., Andersen, P. K., & Vinberg, M. (2021). A nation-wide population-based longitudinal study mapping physical diseases in patients with bipolar disorder and their siblings. Journal of Affective Disorders, 282, 1825. doi:10.1016/j.jad.2020.12.072.CrossRefGoogle ScholarPubMed
Kwok, C. S., Kontopantelis, E., Kuligowski, G., Gray, M., Muhyaldeen, A., Gale, C. P., … Mamas, M. A. (2018). Self-reported sleep duration and quality and cardiovascular disease and mortality: A dose-response meta-analysis. Journal of the American Heart Association, 7(15), e008552. doi:10.1161/JAHA.118.008552.CrossRefGoogle ScholarPubMed
Leboyer, M., Soreca, I., Scott, J., Frye, M., Henry, C., Tamouza, R., & Kupfer, D. J. (2012). Can bipolar disorder be viewed as a multi-system inflammatory disease? Journal of Affective Disorders, 141(1), 110. doi:10.1016/j.jad.2011.12.049.CrossRefGoogle ScholarPubMed
Leclerc, E., Mansur, R. B., Grassi-Oliveira, R., Cordeiro, Q., Kapczinski, F., McIntyre, R. S., & Brietzke, E. (2018). The differential association between history of childhood sexual abuse and body mass index in early and late stages of bipolar disorder. Journal of Affective Disorders, 227, 214218. doi:10.1016/j.jad.2017.10.031.CrossRefGoogle ScholarPubMed
Li, Z., He, Y., Wang, D., Tang, J., & Chen, X. (2017). Association between childhood trauma and accelerated telomere erosion in adulthood: A meta-analytic study. Journal of Psychiatry Research, 93, 6471. doi:10.1016/j.jpsychires.2017.06.002.CrossRefGoogle ScholarPubMed
Lomholt, L. H., Andersen, D. V., Sejrsgaard-Jacobsen, C., Ozdemir, C. M., Graff, C., Schjerning, O., … Nielsen, R. E. (2019). Mortality rate trends in patients diagnosed with schizophrenia or bipolar disorder: A nationwide study with 20 years of follow-up. International Journal of Bipolar Disorders, 7(1), 6. doi:10.1186/s40345-018-0140-x.CrossRefGoogle ScholarPubMed
McIntyre, R. S., Soczynska, J. K., Liauw, S. S., Woldeyohannes, H. O., Brietzke, E., Nathanson, J., … Kennedy, S. H. (2012). The association between childhood adversity and components of metabolic syndrome in adults with mood disorders: Results from the international mood disorders collaborative project. International Journal of Psychiatry in Medicine, 43(2), 165177. doi:10.2190/PM.43.2.e.CrossRefGoogle ScholarPubMed
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389. doi:10.1192/bjp.134.4.382.CrossRefGoogle ScholarPubMed
Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9(11), e1001349. doi:10.1371/journal.pmed.1001349.CrossRefGoogle ScholarPubMed
Pfaff, A., & Schlarb, A. A. (2022). Consequences of child maltreatment: A glimpse at stress and sleep. Journal of Sleep Research, 31(2), e13456. doi:10.1111/jsr.13456.CrossRefGoogle ScholarPubMed
Post, R. M., Altshuler, L. L., Leverich, G. S., Frye, M. A., Suppes, T., McElroy, S. L., … Rowe, M. (2013). Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder. Journal of Affective Disorders, 147(1-3), 288294. doi:10.1016/j.jad.2012.11.020.CrossRefGoogle ScholarPubMed
Roshanaei-Moghaddam, B., & Katon, W. (2009). Premature mortality from general medical illnesses among persons with bipolar disorder: A review. Psychiatric Services, 60(2), 147156. doi:10.1176/appi.ps.60.2.147.CrossRefGoogle ScholarPubMed
Stapp, E. K., Williams, S. C., Kalb, L. G., Holingue, C. B., Van Eck, K., Ballard, E. D., … Gallo, J. J. (2020). Mood disorders, childhood maltreatment, and medical morbidity in US adults: An observational study. Journal of Psychosomatic Research, 137, 110207. doi:10.1016/j.jpsychores.2020.110207.CrossRefGoogle ScholarPubMed
Tursich, M., Neufeld, R. W., Frewen, P. A., Harricharan, S., Kibler, J. L., Rhind, S. G., & Lanius, R. A. (2014). Association of trauma exposure with proinflammatory activity: A transdiagnostic meta-analysis. Translational Psychiatry, 4, e413. doi:10.1038/tp.2014.56.CrossRefGoogle ScholarPubMed
Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis. JAMA Psychiatry, 72(4), 334341. doi:10.1001/jamapsychiatry.2014.2502.CrossRefGoogle ScholarPubMed
WHO. (2018). Management of physical health conditions in adults with severe mental disorders. In Management of physical health conditions in adults with severe mental disorders. Geneva: World Health Organization.Google Scholar
Wolf, E. J., Maniates, H., Nugent, N., Maihofer, A. X., Armstrong, D., Ratanatharathorn, A., … Logue, M. W. (2018). Traumatic stress and accelerated DNA methylation age: A meta-analysis. Psychoneuroendocrinology, 92, 123134. doi:10.1016/j.psyneuen.2017.12.007.CrossRefGoogle ScholarPubMed
Young, R. C., Biggs, J. T., Ziegler, V. E., & Meyer, D. A. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429435. doi:10.1192/bjp.133.5.429.CrossRefGoogle ScholarPubMed
Supplementary material: File

Godin et al. supplementary material
Download undefined(File)
File 42.3 KB