Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar I disorder

Abstract

Background: We explored how childhood trauma (CHT) affects the clinical expression of disorder and quality of life in patients with bipolar I (BP I) disorder.Methods: Euthymic patients (n=116) who subsequently received a diagnosis of BP-I disorder were consecutively included and were interviewed using the following sociodemographic and clinical data forms; Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Childhood Abuse and Neglect Questionnaire (CANQ) and the 36 item Medical Outcome Study Short Form Health Survey (SF 36) The quality of life of BP-I patients with and without a history of CHT were examined.Results: The percentage of trauma was 61.2%. Patients who had CHT had higher frequencies of depressive episodes (t = -2.38, p=0.019), total episodes (t = -2.25, p=0.026), attempted suicide more often (chi(2)=18.12, p=0.003) and had lower scores on the pain subscale of Lhe SF 36 (z=-2.817, p=0.005). In patients with mixed or rapid-cycling episodes, SF-36 subscale scores except general health and pain were Found to be lower.Limitations: Our sample may fail to reflect the general BD population; the patients were included consecutively and consisted of a majority of female patients.Conclusions: CHT plays an important role in the clinical expression of BP-I disorder and having mixed/rapid-cycling episodes negatively affects both physical and mental components, as measured by the SF-36. While both males and females reported experiencing sexual abuse, female BP-I patients complained about pain more often. It is suggested that treatment of BP-1 patients with a history of CHT should differ from that provided for patients with no CHT history.