Guillen-Burgos Hernán, Moreno-Lopez Sergio, Acevedo-Vergara Kaleb, Pérez-Florez Manuel, Pachón-Garcia Catherine, Gálvez-Flórez Juan Francisco
Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia.
School of Health Science, Universidad Simon Bolivar, Carrera 54 No 64-222, Barranquilla, Colombia.
Int J Bipolar Disord. 2023 Feb 10;11(1):7. doi: 10.1186/s40345-023-00289-5.
Bipolar disorder (BD) is higher in developing countries. Childhood trauma exposure is a common environmental risk factor in Colombia and might be associated with a more severe course of bipolar disorder in Low-Middle Income-Countries. We carried out the first case-control study in Colombia using a structural clinical interview and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to describe the prevalence and association between trauma exposure during childhood with a severe course of illness (early age onset, rapid cycling, ideation or suicide attempt, or ≥ 3 hospitalization) in a sample of BD patients.
A total of 114 cases and 191 controls evaluated showed the following results. Cases included 61.4% BD type I and 38.6% BD type II. The median age was 31.5 years (IQR, 75-24) for BD patients and 31 years old (IQR, 38-24) for healthy controls. A higher prevalence of childhood trauma was evidenced in cases compared to controls. Emotional abuse, physical abuse, sexual abuse, physical neglect and emotional neglect evidenced a strong association with severe bipolar disorder (OR = 3.42, p < .001; OR = 4.68, p < .001; OR = 4.30, p = .003; OR = 5.10, p < .001; OR = 5.64, p < .001, respectively).
This is the first association study between childhood trauma exposure as a higher risk for a severe course of illness in BD patients in Colombian. Our findings highlight the higher prevalence of childhood trauma in bipolar patients and the strong association of childhood trauma with severe bipolar disorder. These findings are relevant for screening and evaluating childhood trauma exposure during the course of BD patients.
双相情感障碍（BD）在发展中国家更为常见。童年创伤暴露是哥伦比亚常见的环境风险因素，在低收入和中等收入国家可能与双相情感障碍更严重的病程相关。我们在哥伦比亚开展了第一项病例对照研究，使用结构化临床访谈和儿童创伤问卷简表（CTQ-SF）来描述双相情感障碍患者样本中童年创伤暴露与严重病程（早发、快速循环、有自杀观念或自杀未遂，或≥3次住院）之间的患病率及关联。
共评估了114例病例和191例对照，结果如下。病例包括61.4%的I型双相情感障碍和38.6%的II型双相情感障碍。双相情感障碍患者的中位年龄为31.5岁（四分位间距，75 - 24），健康对照为31岁（四分位间距，38 - 24）。与对照组相比，病例组童年创伤的患病率更高。情感虐待、身体虐待、性虐待、身体忽视和情感忽视与严重双相情感障碍有很强的关联（比值比分别为3.42，p < 0.001；4.68，p < 0.001；4.30，p = 0.003；5.10，p < 0.001；5.64，p < 0.001）。
这是哥伦比亚第一项关于童年创伤暴露作为双相情感障碍患者严重病程更高风险因素的关联研究。我们的研究结果突出了双相情感障碍患者中童年创伤的较高患病率，以及童年创伤与严重双相情感障碍的强烈关联。这些发现对于双相情感障碍患者病程中童年创伤暴露的筛查和评估具有重要意义。
