Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy.
Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
Hum Psychopharmacol. 2021 Jul;36(4):e2783. doi: 10.1002/hup.2783. Epub 2021 Mar 5.
The association between childhood maltreatment (CM) and clinical response to mood stabilizers has been scarcely investigated in bipolar disorder (BD). Therefore, we assessed whether CM affects the response to lithium or anticonvulsant treatments in BD patients.
A retrospective assessment of clinical response to mood stabilizers was conducted in 97 euthymic patients with BD by means of the Alda scale. History of CM was investigated through the Childhood Trauma Questionnaire.
Thirty-seven patients (24 with a history of CM and 13 without CM) were on stable lithium treatment while sixty (35 with a history of CM and 25 without CM) were on stable anticonvulsant treatment. Clinical response to drug treatment did not differ between BD with CM and those without CM in the whole sample as well as in the anticonvulsant-treated subgroup. In the lithium-treated subgroup, a significant negative correlation emerged between childhood physical abuse and clinical response and patients with CM showed a significantly reduced Alda score.
In BD patients, CM did not influence the clinical response to anticonvulsant mood stabilizers whereas it was associated with a poorer response to lithium with childhood physical abuse playing a major role in this effect.
儿童期虐待（CM）与双相情感障碍（BD）患者对心境稳定剂临床反应之间的关联鲜有研究。因此，我们评估了 CM 是否会影响 BD 患者对锂或抗惊厥药物治疗的反应。
通过 Alda 量表对 97 例双相情感障碍患者的心境稳定剂治疗反应进行回顾性评估。通过儿童创伤问卷（Childhood Trauma Questionnaire）调查 CM 病史。
37 例患者（有 CM 病史的 24 例，无 CM 病史的 13 例）接受稳定的锂治疗，60 例患者（有 CM 病史的 35 例，无 CM 病史的 25 例）接受稳定的抗惊厥治疗。在全样本以及抗惊厥治疗亚组中，CM 组和无 CM 组的药物治疗临床反应无差异。在锂治疗亚组中，儿童期躯体虐待与临床反应呈显著负相关，且有 CM 病史的患者 Alda 评分明显降低。
在 BD 患者中，CM 并不影响抗惊厥心境稳定剂的临床反应，而与锂治疗反应较差相关，其中儿童期躯体虐待起主要作用。
