Research Group of Molecular and Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil; Post-Graduation Program in Psychiatry and Medical Psychology, Federal University of São Paulo (Unifesp), São Paulo, SP, Brazil.
Mood Disorders Psychopharmacology Unit (MDPU), University Health Network (UHN), Toronto, ON, Canada.
J Affect Disord. 2018 Feb;227:214-218. doi: 10.1016/j.jad.2017.10.031. Epub 2017 Oct 20.
History of distal stressors such as childhood trauma is a well-established, non-specific vulnerability factor for multiple mental illnesses. The objective of this study was to investigate the possible association between history of childhood trauma and body mass index (BMI) in individuals in early and late stages of bipolar disorder (BD) and to verify is there was any difference in the association of sexual abuse history and obesity in early versus late stages of BD.
Seventy-one euthymic BD-type I patients and eighty-one healthy controls were evaluated using the Childhood Trauma Questionnaire (CTQ) and body mass index (BMI). The association between BMI and CTQ total and subscores were evaluated dividing BD population in early-stage BD-I (less than 10 years since onset of disease) or late-stage BD (more than 10 years).
BD individuals had higher rates of history of childhood trauma than HC, especially sexual and emotional abuse, after adjusting for confounders. We observed a moderating effect of group on the association between BMI and sexual abuse (SA), but not on other modalities of childhood trauma, after adjustments for age, gender, ethnicity, education, alcohol and tobacco use.
Our sample included a predominance of female individuals. The study cross-sectional design does not allow concluding a cause-effect relationship. In dividing the BD subgroups in relation with the time since the onset, we supposed that the natural course of BD is linear. The CTQ is subject to recall bias.
There is a relationship between childhood sexual abuse and BMI, but the direction of the association varies across the different stages of BD-I.
童年创伤等远端应激源的历史是多种精神疾病公认的非特异性脆弱因素。本研究旨在探讨童年创伤史与双相情感障碍（BD）早期和晚期个体体重指数（BMI）之间可能存在的关联，并验证性虐待史与 BD 早期和晚期肥胖之间的关联是否存在差异。
对 71 名双相 I 型情感障碍患者和 81 名健康对照者采用童年创伤问卷（CTQ）和体重指数（BMI）进行评估。通过将双相情感障碍患者分为早期（疾病发病后不到 10 年）或晚期（超过 10 年），评估 BMI 与 CTQ 总分和分量表之间的关联。
在调整混杂因素后，BD 患者的童年创伤史发生率高于 HC，尤其是性虐待和情感虐待。我们观察到，在调整年龄、性别、种族、教育、饮酒和吸烟等因素后，组间对 BMI 和性虐待（SA）之间的关联存在调节作用，但对其他童年创伤方式则没有。
我们的样本包括了大多数女性个体。该研究的横断面设计不允许得出因果关系的结论。在根据发病时间将 BD 亚组进行分组时，我们假设 BD 的自然病程是线性的。CTQ 易受回忆偏差的影响。
童年性虐待与 BMI 之间存在关联，但这种关联的方向在不同的 BD-I 阶段有所不同。
