Developmental Cognitive Neuroscience Research Group, Postgraduation Program in Psychology - Human Cognition, Pontifical Catholic University, Porto Alegre, Brazil.
Acta Psychiatr Scand. 2011 Dec;124(6):427-34. doi: 10.1111/j.1600-0447.2011.01756.x. Epub 2011 Aug 17.
Adverse life events, especially early trauma, play a major role in the course and expression of bipolar disorder (BD). The aim of this article is to present a systematic review about the impact of childhood trauma on the clinical course of BD.
A computer-aided search was performed in Medline, ISI database, EMBASE, PsychInfo, Centre for Reviews and Dissemination, and Databases of Thomson Reuters at April 2011, supplemented by works identified from the reference lists of the first selected papers. Two investigators systematically and independently examined all articles, selecting those according inclusion and exclusion criteria.
Four hundred fifteen articles were identified, of which 19 remained in the review after exclusion criteria were applied. In general, childhood maltreatment predicted worsening clinical course of BD. After assessing the quality of the data and of the measurements, childhood maltreatment can be strongly associated to early onset of disorder, suicidality, and substance abuse disorder in patients with BD.
Data suggest that childhood abuse and neglect are risk factors associated with worsening clinical course of BD. The conclusions should be interpreted with caution because all the studies included are cross-sectional and the majority are showing inconsistencies regarding childhood trauma as independent variable and how it is assessed.
不良生活事件，尤其是早期创伤，在双相情感障碍（BD）的病程和表现中起着重要作用。本文的目的是系统地回顾童年创伤对 BD 临床病程的影响。
2011 年 4 月，我们在 Medline、ISI 数据库、EMBASE、PsychInfo、循证医学中心和汤姆森路透数据库中进行了计算机辅助检索，并通过参考最初选择的论文的参考文献确定了其他一些论文。两名研究人员系统地、独立地检查了所有文章，根据纳入和排除标准选择了这些文章。
共确定了 415 篇文章，其中 19 篇在排除标准后仍保留在综述中。一般来说，儿童期虐待预示着 BD 的临床病程恶化。在评估数据和测量质量后，儿童虐待可以与 BD 患者的发病年龄早、自杀和物质滥用障碍强烈相关。
数据表明，儿童期虐待和忽视是与 BD 临床病程恶化相关的危险因素。由于所有纳入的研究都是横断面研究，而且大多数研究在童年创伤作为独立变量及其评估方式方面存在不一致，因此应谨慎解释这些结论。
