Maguire Chrissie, McCusker Christopher G, Meenagh Ciaran, Mulholland Ciaran, Shannon Ciaran
Department of Psychology, Queens University of Belfast, Belfast, Northern Ireland, UK.
Bipolar Disord. 2008 Mar;10(2):293-302. doi: 10.1111/j.1399-5618.2007.00504.x.
This study examined: (i) the prevalence of trauma in a bipolar disorder (BD) sample, and (ii) how trauma histories mediated by interpersonal difficulties and alcohol dependence impact on the severity of BD. The prevalence of posttraumatic stress disorder (PTSD) and its relationship to outcomes in BD were also examined.
Sixty participants were recruited from a geographically well-defined mental health service in Northern Ireland. Self-reported trauma histories, PTSD, interpersonal difficulties and alcohol dependence and were examined in relation to illness severity.
A high prevalence of trauma was found. Trauma predicted the frequency of hospital admissions (R(2) = 0.08), quality of life (R(2) = 0.23) and inter-episode depressive symptoms (R(2) = 0.13). Interpersonal difficulties, but not alcohol dependence, appeared to play an important role in mediating these adverse effects. While only 8% of the sample met criteria for active PTSD, this comorbid disorder was associated with BD severity.
This study indicates that awareness of trauma is important in understanding individual differences in bipolar presentations. The theoretical and clinical implications of evidence that trauma is related to more adverse outcomes in BD are discussed. The finding that interpersonal difficulties mediate the relationship between trauma and BD severity is novel. The need for adjunctive evidence-based treatments targeting interpersonal difficulties is considered.
本研究考察了：（i）双相情感障碍（BD）样本中创伤的患病率，以及（ii）人际困难和酒精依赖介导的创伤史如何影响BD的严重程度。还考察了创伤后应激障碍（PTSD）的患病率及其与BD结局的关系。
从北爱尔兰一个地理范围明确的心理健康服务机构招募了60名参与者。对自我报告的创伤史、PTSD、人际困难和酒精依赖进行了检查，并与疾病严重程度相关联。
发现创伤的患病率很高。创伤可预测住院频率（R² = 0.08）、生活质量（R² = 0.23）和发作间期抑郁症状（R² = 0.13）。人际困难而非酒精依赖似乎在介导这些不良影响方面发挥了重要作用。虽然只有8%的样本符合活动性PTSD的标准，但这种共病与BD严重程度相关。
本研究表明，认识到创伤对于理解双相情感障碍表现的个体差异很重要。讨论了创伤与BD中更不良结局相关的证据的理论和临床意义。人际困难介导创伤与BD严重程度之间关系的这一发现是新颖的。考虑了针对人际困难的辅助性循证治疗的必要性。
