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Pretreatment and outcome correlates of past sexual and physical trauma in 118 bipolar I disorder patients with a first episode of psychotic mania

journal contribution
posted on 2010-05-01, 00:00 authored by P Conus, S Cotton, B G Schimmelmann, Michael BerkMichael Berk, R Daglas, P D McGorry, M Lambert
OBJECTIVES: To assess the prevalence and correlates of childhood and adolescent sexual and/or physical abuse (SPA) in bipolar I disorder (BDI) patients treated for a first episode of psychotic mania. METHODS: The Early Psychosis Prevention and Intervention Centre admitted 786 first-episode psychosis patients between 1998 and 2000. Data were collected from patients' files using a standardized questionnaire. A total of 704 files were available; 43 were excluded because of a nonpsychotic diagnosis at endpoint and 3 due to missing data regarding past stressful events. Among 658 patients with available data, 118 received a final diagnosis of BDI and were entered in this study. RESULTS: A total of 80% of patients had been exposed to stressful life events during childhood and adolescence and 24.9% to SPA; in particular, 29.8% of female patients had been exposed to sexual abuse. Patients who were exposed to SPA had poorer premorbid functioning, higher rates of forensic history, were less likely to live with family during treatment period, and were more likely to disengage from treatment. CONCLUSIONS: SPA is highly prevalent in BDI patients presenting with a first episode of psychotic mania; exposed patients have lower premorbid functional levels and poorer engagement with treatment. The context in which such traumas occur must be explored in order to determine whether early intervention strategies may contribute to diminish their prevalence. Specific psychological interventions must also be developed.

History

Journal

Bipolar disorders

Volume

12

Issue

3

Pagination

244 - 252

Publisher

Wiley

Location

Hoboken, N.J.

ISSN

1398-5647

eISSN

1399-5618

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2010, The Authors