Guillen-Burgos Hernán F, Gálvez-Flórez Juan F, Moreno-López Sergio, Solano María C, Kwan Angela T H, Santamaria-Garcia Hernando, Gómez-Restrepo Carlos, McIntyre Roger S
Center for Clinical and Translational Research, Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Carrera 54 # 64-22, Barranquilla, Colombia.
Faculty of Medicine, Center for Clinical and Translational Research, Universidad El Bosque, Bogotá, Colombia.
Sci Rep. 2025 May 7;15(1):15876. doi: 10.1038/s41598-025-98537-4.
Childhood trauma (CT) is associated with an earlier onset and a more severe course of bipolar disorder (BD). However, the specific impact of CT on bipolar depression remains unclear. Herein, this study aimed to investigate the effect of CT using depressive episode frequency as a threshold for disease burden and severity. A cohort of 146 participants with BD was followed for 3 years. The effects of CT on mood episodes, hospital readmissions, suicidal ideation, and behavior were analyzed. A high number of depressive episodes were identified in participants with BD and CT exposure, with the effect being more pronounced in BD II than in BD I. A threshold of ≥4 depressive episodes serves as a sensitivity cutoff point to detect associations with severe outcomes, such as early readmission and suicidal ideation and behavior. The presence of CT increases the risk of experiencing at least one severe outcome by 80%. In our cohort, a cutoff point of ≥4 depressive episodes mediated the effect of CT on at least one severe outcome (early readmission or suicidal ideation and behavior). The study is limited by its non-probabilistic sample, recall bias, and moderate receiver operating characteristic curve value. The findings reinforce the association between CT and BD severity, highlighting the significantly higher number of depressive episodes in individuals with CT. This underscores CT as a risk factor for depressive predominant polarity and more frequent mood episodes in BD.
童年创伤（CT）与双相情感障碍（BD）的发病更早及病程更严重相关。然而，CT对双相抑郁的具体影响仍不明确。在此，本研究旨在以抑郁发作频率作为疾病负担和严重程度的阈值，探讨CT的影响。对146名双相情感障碍参与者进行了为期3年的随访。分析了CT对情绪发作、再次入院、自杀观念及行为的影响。在有双相情感障碍且暴露于童年创伤的参与者中发现了大量抑郁发作，这种影响在双相II型障碍中比在双相I型障碍中更为明显。≥4次抑郁发作的阈值可作为一个敏感性临界点，以检测与严重后果（如早期再次入院、自杀观念及行为）的关联。童年创伤的存在使经历至少一种严重后果的风险增加80%。在我们的队列中，≥4次抑郁发作的临界点介导了童年创伤对至少一种严重后果（早期再次入院或自杀观念及行为）的影响。本研究受限于其非概率样本、回忆偏倚及中等的受试者工作特征曲线值。这些发现强化了童年创伤与双相情感障碍严重程度之间的关联，突出了童年创伤患者中抑郁发作次数显著更多的情况。这强调了童年创伤是双相情感障碍中抑郁为主极性及更频繁情绪发作的一个危险因素。
