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Clinical and neuroendocrine correlates of childhood maltreatment history in adults with bipolar disorder

Published online by Cambridge University Press:  19 July 2023

S. Donato ,
N. Attianese ,
M. Battipaglia ,
R. Ceres ,
A. M. Monteleone ,
G. D’Agostino  and
G. Cascino
S. Donato*
Affiliation:
1University “L. Vanvitelli”, napoli
N. Attianese
Affiliation:
1University “L. Vanvitelli”, napoli
M. Battipaglia
Affiliation:
1University “L. Vanvitelli”, napoli
R. Ceres
Affiliation:
1University “L. Vanvitelli”, napoli
A. M. Monteleone
Affiliation:
1University “L. Vanvitelli”, napoli
G. D’Agostino
Affiliation:
2University, “Scuola Medica Salernitana”, salerno, Italy
G. Cascino
Affiliation:
2University, “Scuola Medica Salernitana”, salerno, Italy
*
*Corresponding author.

Abstract

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Introduction

Childhood maltreatment (CM) has been associated to an increased risk of developing bipolar disorder (BD). A role of the hypothalamus-pituitary-adrenal (HPA) axis in mediating trauma-related risk for adult psychopathology has been suggested but scarcely investigated in BD.

Objectives

The aim of this study is to explore the impact of childhood maltreatment on clinical features of BD and on the activity of the HPA axis.

Methods

One hundred and six patients participated in the study. On the basis of their history of childhood trauma, as assessed by the Childhood Trauma Questionnaire (CTQ), they were divided into a group with a history of childhood maltreatment (CM+) and a group without (CM−). Twenty-nine participants (16 with a history of childhood trauma and 13 without) underwent the cortisol awakening response (CAR) test. Saliva cortisol concentrations were determined by an enzyme immunoassay method, using a commercially available ELISA kit.

Results

According to CTQ, 62 had a history of childhood maltreatment and 44 had not. CM was significantly more frequent in females than males. CM+ patients showed significant higher body mass index (p = .01), number of suicide attempts (p = .03), and more severe mania symptoms (p = .01) than CM− ones. Significant associations between lifetime suicide attempts and any type of childhood maltreatment (OR = 2.79; CI = 1.01-7.73) and between emotional abuse and the presence of psychotic symptoms (OR = 2.74, CI = 1.11-6.74) or mixed mood episodes were found (OR = 2.62, CI = 1.07-6.43). Moreover, CM+ individuals with BD exhibited a significantly reduced CAR with respect to CM− ones.

Conclusions

Our results add to literature findings showing a worse clinical course in BD patients with a history of childhood maltreatment and show for the first time that childhood trauma exposure is associated to impaired CAR in adults with BD.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S273 - S274
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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