Riemann Georg, Chrispijn Melissa, Kupka Ralph W, Penninx Brenda W J H, Giltay Erik J
Fontys, University of Applied Science, Emmasingel 28, 5611 AZ Eindhoven, the Netherlands.
Dimence Mental Health, Center for Bipolar Disorders, Deventer, the Netherlands.
J Affect Disord. 2024 Oct 15;363:358-364. doi: 10.1016/j.jad.2024.07.101. Epub 2024 Jul 17.
Childhood trauma, including emotional neglect, emotional abuse, physical abuse, and sexual abuse, may contribute to borderline personality features like affective instability, identity problems, negative relationships, and self-harm. This study aims to explore how different types of childhood trauma affect these features in bipolar versus unipolar depressive disorders.
We included 839 participants of the Netherlands Study of Depression and Anxiety (NESDA) with a lifetime diagnosis of major depressive disorder single episode (MDDS; N = 443), recurrent major depressive disorder (MDD-R; N = 331), or bipolar disorder (BD; N = 65). Multivariate regression was used to analyze data from the Childhood Trauma Interview and borderline features (from the self-report Personality Assessment Inventory).
On average, participants were 48.6 years old (SD: 12.6), with 69.2 % being women, and 50.3 % of participants assessed positive for childhood trauma. Adjusted analyses revealed that participants diagnosed with BD, followed by MDD-R, exhibited the highest number of borderline personality features. Additionally, within the entire group, a strong association was found between childhood trauma, especially emotional neglect, and the presence of borderline personality features.
Given the high prevalence of childhood trauma and borderline personality features, screening for these factors in individuals with mood disorders is crucial. Identifying these elements can inform and enhance the management of the often fluctuating and complex nature of these comorbid conditions, leading to more effective and tailored treatment strategies.
童年创伤,包括情感忽视、情感虐待、身体虐待和性虐待,可能导致边缘型人格特征,如情感不稳定、身份认同问题、不良人际关系和自我伤害行为。本研究旨在探讨不同类型的童年创伤如何影响双相情感障碍与单相抑郁症患者的这些特征。
我们纳入了荷兰抑郁与焦虑研究(NESDA)的839名参与者,他们被诊断患有单次发作的重度抑郁症(MDDS;N = 443)、复发性重度抑郁症(MDD-R;N = 331)或双相情感障碍(BD;N = 65)。采用多变量回归分析童年创伤访谈数据和边缘型人格特征(来自自陈式人格评估量表)。
参与者的平均年龄为48.6岁(标准差:12.6),69.2%为女性,50.3%的参与者童年创伤评估呈阳性。校正分析显示,被诊断为双相情感障碍的参与者,其次是复发性重度抑郁症患者,表现出最多的边缘型人格特征。此外,在整个研究组中,发现童年创伤,尤其是情感忽视,与边缘型人格特征的存在之间存在强烈关联。
鉴于童年创伤和边缘型人格特征的高患病率,对情绪障碍患者进行这些因素的筛查至关重要。识别这些因素可以为这些共病情况通常波动且复杂的性质的管理提供信息并加以改进,从而制定更有效且个性化的治疗策略。