Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy.
Curr Neuropharmacol. 2024;22(1):152-158. doi: 10.2174/1570159X21666230213155249.
Bipolar disorders (BD) in youth are associated with a high risk of self-harm behaviors. Childhood trauma (CT) is a relevant environmental stressor that is related to both BD diagnosis and self-harm in adulthood. It is not yet established whether CT may impact self-harm risk in youth. Therefore, the aim of this study was to investigate the distribution patterns of CT in youth BD with and without self-harm.
We assessed 273 participants (aged 13-25 years), 96 youths with BD according to DSM-5 criteria and 177 healthy controls (HC). History of CT was obtained using the Childhood Trauma Questionnaire (CTQ). The association between CT and self-harm was tested using multivariate statistical models.
Over 45% of participants with BD reported lifetime self-harm. The BD Self-harm group reported more emotional abuse, emotional neglect, sexual abuse, and physical abuse than HC. The BD No-Self-harm group reported more emotional abuse than HC. The BD Self-harm group reported more emotional abuse and neglect than the BD No-Self-harm group. The BD Self-harm group also reported separated parents, hospitalizations, smoking, use of antiepileptics, antipsychotics and lithium. Emotional abuse was an independent predictor of self-harm in youths with BD.
Findings support the importance of assessing CT, in particular emotional abuse, in youth with BD at risk for self-harm.
青少年双相情感障碍（BD）与自伤行为的风险较高有关。童年创伤（CT）是一种相关的环境应激源，与 BD 诊断和成年后的自伤有关。目前尚不清楚 CT 是否会影响青少年的自伤风险。因此，本研究旨在调查有和无自伤的青少年 BD 中 CT 的分布模式。
我们评估了 273 名参与者（年龄 13-25 岁），96 名符合 DSM-5 标准的青少年 BD 和 177 名健康对照者（HC）。使用童年创伤问卷（CTQ）评估 CT 病史。使用多变量统计模型测试 CT 与自伤之间的关联。
超过 45%的 BD 患者报告有终生自伤。BD 自伤组比 HC 组报告更多的情感虐待、情感忽视、性虐待和身体虐待。BD 无自伤组比 HC 组报告更多的情感虐待。BD 自伤组比 BD 无自伤组报告更多的情感虐待和忽视。BD 自伤组还报告了父母离异、住院、吸烟、使用抗癫痫药、抗精神病药和锂。情感虐待是 BD 青少年自伤的独立预测因素。
研究结果支持在有自伤风险的青少年 BD 中评估 CT（特别是情感虐待）的重要性。
