Erten Evrim, Funda Uney Aslı, Saatçioğlu Ömer, Özdemir Armağan, Fıstıkçı Nurhan, Çakmak Duran
Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
Esenyurt State Hospital, Istanbul, Turkey.
J Affect Disord. 2014 Jun;162:107-13. doi: 10.1016/j.jad.2014.03.046. Epub 2014 Apr 1.
We explored how childhood trauma (CHT) affects the clinical expression of disorder and quality of life in patients with bipolar I (BP-I) disorder.
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.
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 (χ(2)=18.12, p=0.003) and had lower scores on the pain subscale of the 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.
Our sample may fail to reflect the general BD population; the patients were included consecutively and consisted of a majority of female patients.
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-I patients with a history of CHT should differ from that provided for patients with no CHT history.
我们探讨了童年创伤（CHT）如何影响双相I型（BP-I）障碍患者的疾病临床表现和生活质量。
连续纳入116例随后被诊断为BP-I障碍的心境正常患者，并使用以下社会人口统计学和临床数据表格进行访谈；青年躁狂评定量表（YMRS）、汉密尔顿抑郁评定量表（HDRS）、童年虐待与忽视问卷（CANQ）以及36项医学结局研究简表健康调查（SF-36）。对有和没有CHT病史的BP-I患者的生活质量进行了检查。
创伤发生率为61.2%。有CHT的患者抑郁发作频率更高（t=-2.38，p=0.019），总发作频率更高（t=-2.25，p=0.026），自杀未遂更频繁（χ(2)=18.12，p=0.003），并且在SF-36疼痛分量表上得分更低（z=-2.817，p=0.005）。在有混合发作或快速循环发作的患者中，发现除一般健康和疼痛外，SF-36分量表得分更低。
我们的样本可能无法反映双相障碍的总体人群；患者是连续纳入的，且大多数为女性患者。
CHT在BP-I障碍的临床表现中起重要作用，并且有混合/快速循环发作会对SF-36所测量的身心成分产生负面影响。虽然男性和女性都报告遭受过性虐待，但女性BP-I患者更常抱怨疼痛。建议对有CHT病史的BP-I患者的治疗应与无CHT病史的患者不同。
