Can sexual abuse cause bipolar disorder-

The thought of developing bipolar disorder seemingly out of nowhere can be scary. Also known as manic-depressive illness, the disease can be severe and life-changing. Drastic changes in mood, including lows that leave you unable to function and highs that remove you from reality, can make it nearly impossible to make it through a daily job or routine. Scientists have known for some time that certain genes are likely to cause bipolar disorder, and some of these genes are also linked to an increased risk of schizophrenia and alcoholism. The first thing that comes to mind when scientists discuss bipolar disorder is its tie to certain genes that may cause it.

Can sexual abuse cause bipolar disorder

Freshwater aquarium stocking guides disturbances observed in BD Geoffroy et al. Biol Psychiatry. Analysis of telomere attrition in bipolar disorder. Another limitation to our study was that we did not have data on childhood trauma for the healthy control group at time present. Chantal Henry, Email: rf. People with bipolar disorder more than twice as likely to have suffered childhood adversity. To assess the potential non-linearities in the associations between continuous covariates e. Trauma subtypes assessed by the CTQ Bernstein et al. If a person already suffers from anxiety, or other mental illnesses like post-traumatic stress disorder PTSD or social phobia, they may have a higher Can sexual abuse cause bipolar disorder of developing bipolar disorder, according to the NIH.

Furries erotic sex animation and artwork. Childhood trauma as a risk factor for psychiatric disorders across diagnostic boundaries

Lacks control, It just happend to her. Affective lability is suggested as a cuse feature of BD Aminoff et al. Epigenetic molecular mechanisms One adaptive mechanism to help modulate stress response is to act through subtle modifications of gene expression, primarily through epigenetic mechanisms such as methylation and histone modifications. Are trauma and dissociation related to treatment resistance in patients with obsessive-compulsive disorder? Abstract This review will discuss the role of childhood trauma in Can sexual abuse cause bipolar disorder disorders. Childhood cuse as a risk factor for psychiatric disorders across diagnostic boundaries The WHO World Health Organization estimates that a quarter of all adults report having been physically abused as a child, with childhood sexual abuse reported by one in five women and one in 13 men WHO Library Cataloguing-in-Publication Data A study found that people with bipolar disorder may lose more brain abuxe matter while aging, and there was less gray matter in the prefrontal brain regions in general. In healthy populations, childhood trauma is also more frequently reported by females than males, specifically for sexual abuse, while physical abuse is more frequently reported by healthy males Fisher et al. Those with the most severe bipolar often do have a history of abuse, however - a worse course of illness, on average. But it's said that it has to do with genes as well. Author information Article notes Copyright and License information Disclaimer. Verbal abuse, like physical Can sexual abuse cause bipolar disorder sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder. Childhood maltreatment and bipolar disorder: a critical review of the evidence. She will tell Against pornography statistics family member he hits her and she lies to the rest.

The researchers identified 19 studies from hundreds published between and which gathered data from millions of patient records, interviews and assessments.

  • This review will discuss the role of childhood trauma in bipolar disorders.
  • Chat or rant, adult content, spam, insulting other members, show more.
  • The thought of developing bipolar disorder seemingly out of nowhere can be scary.

Use the link below to share a full-text version of this article with your friends and colleagues. Learn more.

If you have previously obtained access with your personal account, Please log in. If you previously purchased this article, Log in to Readcube. Log out of Readcube. Click on an option below to access. Log out of ReadCube. Maniglio R. The impact of child sexual abuse on the course of bipolar disorder: a systematic review. Bipolar Disord — Objectives: The aim of this review was to elucidate the impact of child sexual abuse on all clinical phenomena that occur after the onset of bipolar disorder, including associated clinical features that are not part of the diagnostic criteria for the disorder.

Methods: Five databases were searched and supplemented with a hand search of reference lists from retrieved papers. Study quality was assessed using a validated quality assessment tool. Blind assessments of study eligibility and quality were conducted by two independent researchers to reduce bias, minimize errors, and enhance the reliability of findings. Disagreements were resolved by consensus. Results: Eighteen studies that included a total of adults and youths with bipolar disorder and met the minimum quality criteria necessary to ensure objectivity and not invalidate results were analyzed.

In regard to the association between child sexual abuse and other clinical variables concerning the course of bipolar disorder, evidence was scant or conflicting. Conclusions: Child sexual abuse is associated either directly or indirectly with some clinical phenomena that represent a more severe form of bipolar disorder.

Although such a traumatic experience may directly affect the development of posttraumatic stress disorder, the effects of early sexual abuse on later suicidal behavior, substance abuse, and psychotic symptoms may operate through the mediating influences of certain psychopathological or neurobiological variables.

Volume 15 , Issue 4. The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account. If the address matches an existing account you will receive an email with instructions to retrieve your username. Review Article. Roberto Maniglio, PsyD, Ph. Tools Request permission Export citation Add to favorites Track citation.

Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article.

Get access to the full version of this article. View access options below. You previously purchased this article through ReadCube. Institutional Login. Log in to Wiley Online Library. Purchase Instant Access. View Preview. Learn more Check out. Abstract Maniglio R. Citing Literature. Volume 15 , Issue 4 June Pages Related Information. Close Figure Viewer.

Browse All Figures Return to Figure. Previous Figure Next Figure. Email or Customer ID. Forgot password? Old Password. New Password. Password Changed Successfully Your password has been changed.

Returning user. Request Username Can't sign in? Forgot your username? Enter your email address below and we will send you your username. Forgot your password?

A previous study has linked childhood trauma specifically emotional abuse to later affective lability in personality disorders and in BD Goodman et al. Published online Jan The link between childhood trauma and depression: insights from HPA axis studies in humans. Asker's rating. Here, homozygotes for the short variant of the 5HTTLPR and trauma have increased the risk of suicide attempts and an earlier age of onset compared to all other groups. Im jealous of everyone and everything all the time? Leucocyte telomere length and risk of cardiovascular disease: systematic review and meta-analysis.

Can sexual abuse cause bipolar disorder

Can sexual abuse cause bipolar disorder

Can sexual abuse cause bipolar disorder

Can sexual abuse cause bipolar disorder

Can sexual abuse cause bipolar disorder

Can sexual abuse cause bipolar disorder. Pagination

Not saying that something that psychologically traumatizing couldn't trigger bi-polar and parania, because it most likely could.. Living in such an unstable environmet. The disorder is still being researched, but you can always read more about it and see if ya find useful info on it.. So sorry about your friend, no one should have to deal with that.. But what doesn't kill ya only makes ya stronger! All my luck to her, and shes lucky to have a friend like you.

Add a comment. Asker's rating. This could be a Schizoaffective Disorder with manic-depressive and obsessive-compulsive features. Are you looking to diagnose properly? If this were all in one person, I'd say this person should have one symptom at a time addressed. But just to let you know, I doubt you'll get any "professional" to answer your question here. Just a few of us who have worked in the field forever. There is a theory in psychology called the "diathesis-stress model" which basically says that people are pre-conditioned to develop certain mental illnesses, but that these illnesses are not brought on until the right amount of stress is introduced to that person.

So your friend was born with the genetic make-up to develop bipolar disorder the diathesis , but the molestation in her childhood the stress triggered the illness to actually occur. It's a combination of nature genetics AND nurture things that happen to you in your lifetime. Source s : psychology undergraduate student. It is, at it's core, however, a chemical embalance in the brain.

Hmmm, I am not sure, Though here are some ideas why.. Genetics 2. Learned that way 3. Lacks control, It just happend to her. She thinks she has it, Though doesint really Factitious disorder Iunno, Though it could possibly be any one of those, I may not have said it clearly, though I tried.

Source s : I was abused I am bipolar. Yes it can duh. Search the web you'll find aloooottt of info on this topic. Existing questions. Related Questions For any psychiatric professionals out there who know about early-onset Bipolar Disorder? Does child abuse cause a person to become bipolar? Who can explain me bipolar disorder? More questions. Bipolar and abuse? MA and BE wrote the initial draft. These organizations had no role in the design of the study, the writing of the report, or the decision to submit the paper for publication.

Monica Aas, Email: on. Chantal Henry, Email: rf. Ole A. Andreassen, Email: on. Frank Bellivier, Email: rf. Ingrid Melle, Email: on. Bruno Etain, Email: rf. National Center for Biotechnology Information , U. Int J Bipolar Disord. Published online Jan Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Sep 25; Accepted Dec This article has been cited by other articles in PMC.

Abstract This review will discuss the role of childhood trauma in bipolar disorders. Childhood trauma as a risk factor for psychiatric disorders across diagnostic boundaries The WHO World Health Organization estimates that a quarter of all adults report having been physically abused as a child, with childhood sexual abuse reported by one in five women and one in 13 men WHO Library Cataloguing-in-Publication Data Childhood trauma as a risk factor in BD In , Fisher identified only six robust studies exploring childhood trauma in BD suggesting an association with childhood trauma.

Childhood trauma and severity of the clinical expression of BD There are consistent indications that childhood traumatic events are associated with various severe clinical characteristics of BD, including an earlier onset of the illness Garno et al.

Gender issues and trauma subtypes Several studies show that females with BD report childhood trauma more frequently than males Etain et al. Open in a separate window. Childhood trauma, psychological dimensions, cognition, and brain imaging abnormalities in BD One might postulate that childhood trauma is driving clinical outcomes psychiatric diagnoses or certain clinical features such as suicide attempts through non-specific dimensions of psychopathology e.

Interactions between childhood trauma and later stressors in BD A two-hits model of susceptibility has been proposed in psychosis, and could show relevance for BD Cannon et al. Biological systems implicated in the association between childhood trauma and BD It is beyond the scope of this article to review all the relevant biological systems that could play a role in mediating the impact of childhood trauma on the risk of developing BD or a more severe form of the disorder.

Underlying molecular mechanisms in BD Several mechanisms are likely to be involved in mediating the consequences of childhood trauma at the molecular level, with interactions between childhood trauma and genetic variants, epigenetics mechanisms and shortened telomere length being only a few. Gene-environment interactions in BD Exposure to childhood trauma is thought to interact with various susceptibility genes to increase the risk of BD, or to a more severe clinical expression of the expression of the disorder.

Epigenetic molecular mechanisms One adaptive mechanism to help modulate stress response is to act through subtle modifications of gene expression, primarily through epigenetic mechanisms such as methylation and histone modifications. Telomere length Telomeres are the DNA-based caps and protein structures at the chromosome tips, which shorten after each cell division, their length being used as a marker of biological aging Shalev et al. Implications for clinical assessment and treatment First, a routine assessment of childhood trauma in both the early phases and established cases of BD should be undertaken due to the heightened risk of developing a more severe illness over time.

Perspectives and research gaps Childhood traumatic events are potential risk factors, both for developing BD and presenting a more severe disorder over time. Competing interests The authors declare that they have no competing interests. Contributor Information Monica Aas, Email: on. Childhood trauma and cognitive function in first-episode affective and non-affective psychosis.

Schizophr Res. Is there a link between childhood trauma, cognition, and amygdala and hippocampus volume in first-episode psychosis?

Affective lability in patients with bipolar disorders is associated with high levels of childhood trauma. Psychiatry Res. Additive effects of childhood abuse and cannabis abuse on clinical expressions of bipolar disorders. Psychol Med. J Psychiatr Res. Prevalence and clinical impact of childhood trauma in patients with severe mental disorders.

J Nerv Ment Dis. An association between affective lability and executive functioning in bipolar disorder. Genetic and childhood trauma interaction effect on age of onset in bipolar disorder: an exploratory analysis. J Affect Disord. The enduring effects of early-childhood adversities and troubled sleep among Canadian adults: a population-based study. Sleep Med. Mol Psychiatry. Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity.

Br J Psychiatry. Chronobiol Int. The serotonin transporter genotype modulates the relationship between early stress and adult suicidality in bipolar disorder.

Bipolar Disord. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry. Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatr Scand. Impact of childhood abuse on the course of bipolar disorder: a replication study in U.

Brain-derived neurotrophic factor and inflammatory markers in school-aged children with early trauma. Priming the brain for psychosis: maternal inflammation during fetal development and the risk of later psychiatric disorder. Childhood maltreatment and inflammatory markers: a systematic review. Effects of stress and social support on recurrence in bipolar disorder. Is bipolar disorder associated with accelerating aging? A meta-analysis of telomere length studies.

C-reactive protein alterations in bipolar disorder: a meta-analysis. J Clin Psychiatry. Childhood maltreatment and clinical outcomes of bipolar disorder. Childhood sexual abuse and suicidal behavior: a meta-analysis. The effect of childhood trauma on pharmacological treatment response in depressed inpatients.

Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse. Clin Psychol Rev. Childhood maltreatment is associated with a sex-dependent functional reorganization of a brain inhibitory control network.

Hum Brain Mapp. The load of short telomeres is increased and associated with lifetime number of depressive episodes in bipolar II disorder. Beyond genetics: childhood affective trauma in bipolar disorder.

Preferential association between childhood emotional abuse and bipolar disorder. J Trauma Stress. Childhood trauma is associated with severe clinical characteristics of bipolar disorders. Clinical features associated with trait-impulsiveness in euthymic bipolar disorder patients.

Interaction between SLC6A4 promoter variants and childhood trauma on the age at onset of bipolar disorders. Sci Rep. The developmental antecedents of illicit drug use: evidence from a year longitudinal study.

Drug Alcohol Depend. Epigenetic programming of stress responses through variations in maternal care. Ann N Y Acad Sci. Gender differences in the association between childhood abuse and psychosis. Childhood maltreatment and bipolar disorder: a critical review of the evidence. Mind Brain. The amygdala and emotion. Curr Opin Neurobiol. Impact of childhood abuse on the clinical course of bipolar disorder. Predictors of trait aggression in bipolar disorder.

Sleep in patients with remitted bipolar disorders: a meta-analysis of actigraphy studies. Morning cortisol levels in schizophrenia and bipolar disorder: a meta-analysis. The role of childhood trauma in differences in affective instability in those with personality disorders. CNS Spectr.

Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation. The effect of lifetime adversities on resistance to antipsychotic treatment in schizophrenia patients.

Leucocyte telomere length and risk of cardiovascular disease: systematic review and meta-analysis. The link between childhood trauma and depression: insights from HPA axis studies in humans. Emotional hyper-reactivity as a fundamental mood characteristic of manic and mixed states. Eur Psychiatry. Affective lability and affect intensity as core dimensions of bipolar disorders during euthymic period. Do corticosteroids damage the brain?

J Neuroendocrinol. Childhood traumatic experiences of patients with bipolar disorder type I and type II. Childhood abuse as a risk factor for psychotic experiences. Negative life events and time to recovery from episodes of bipolar disorder.

J Abnorm Psychol. Life events and bipolar disorder: implications from biological theories. Psychol Bull. Traumatic life events in bipolar disorder: impact on BDNF levels and psychopathology.

The influence of life events on first and recurrent admissions in bipolar disorder. Causes of decreased life expectancy over the life span in bipolar disorder.

Nat Neurosci. Childhood adversities and quality of sleep in adulthood: a population-based study of 26, Finns. Circadian clock and stress interactions in the molecular biology of psychiatric disorders. Curr Psychiatry Rep. EMDR therapy modulates the default mode network in a subsyndromal, traumatized bipolar patient. Childhood trauma associates with clinical features of bipolar disorder in a sample of Chinese patients. Analysis of telomere attrition in bipolar disorder. Shortened telomere length is associated with increased risk of cancer: a meta-analysis.

PLoS One. Cognitive-behavioural interventions for children who have been sexually abused. Cochrane Database Syst Rev. Prevalence of child sexual abuse among adults and youths with bipolar disorder: a systematic review. Emotional abuse in childhood is a differential factor for the development of depression in adults.

Brain-derived neurotrophic factor val66met genotype and early life stress effects upon bipolar course. A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness.

J Consult Clin Psychol. Cytokines in bipolar disorder vs. Neurobiological consequences of childhood trauma. The preeminent role of childhood abuse and neglect in vulnerability to major psychiatric disorders: toward elucidating the underlying neurobiological mechanisms. Sleep-wake disturbance in interepisode bipolar disorder and high-risk individuals: a systematic review and meta-analysis.

Sleep Med Rev. Combined effect of TLR2 gene polymorphism and early life stress on the age at onset of bipolar disorders. Clinical and dimensional characteristics of euthymic bipolar patients with or without suicidal behavior. Verbal abuse, like physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder.

Telomeres and early-life stress: an overview. Biol Psychiatry. Staff response to abuse histories of psychiatric inpatients. Aust NZ J Psychiatry. Instruments for the assessment of childhood trauma in adults. The association between childhood trauma and facial emotion recognition in adults with bipolar disorder.

Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma. Relationship between early-life stress load and sleep in psychiatric outpatients: a sleep diary and actigraphy study.

Stress Health. Glucocorticoid programming. Ann NY Acad Sci. Are trauma and dissociation related to treatment resistance in patients with obsessive-compulsive disorder? Soc Psychiatry Psychiatr Epidemiol. Stress and telomere biology: a lifespan perspective. Trauma and psychosis: an analysis of the National Comorbidity Survey. Child physical abuse and adult mental health: a national study.

Correlates of stress reactivity in patients with bipolar disorder. Schizophr Bull. Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis. Transl Psychiatry. Gene-environment interactions in severe mental illness.

Front Psychiatry. Enhanced amygdala reactivity to emotional faces in adults reporting childhood emotional maltreatment.

This review will discuss the role of childhood trauma in bipolar disorders. This review contributes to a new understanding of the negative consequences of early life stress, as well as setting childhood trauma in a biological context of susceptibility and discussing novel long-term pathophysiological consequences in bipolar disorders. Childhood traumatic events are risk factors for developing bipolar disorders, in addition to a more severe clinical presentation over time primarily an earlier age at onset and an increased risk of suicide attempt and substance misuse.

Childhood trauma leads to alterations of affect regulation, impulse control, and cognitive functioning that might decrease the ability to cope with later stressors. Childhood trauma interacts with several genes belonging to several different biological pathways [Hypothalamic—pituitary—adrenal HPA axis, serotonergic transmission, neuroplasticity, immunity, calcium signaling, and circadian rhythms] to decrease the age at the onset of the disorder or increase the risk of suicide.

Epigenetic factors may also be involved in the neurobiological consequences of childhood trauma in bipolar disorder. Biological sequelae such as chronic inflammation, sleep disturbance, or telomere shortening are potential mediators of the negative effects of childhood trauma in bipolar disorders, in particular with regard to physical health.

The main clinical implication is to systematically assess childhood trauma in patients with bipolar disorders, or at least in those with a severe or instable course. The challenge for the next years will be to fill the gap between clinical and fundamental research and routine practice, since recommendations for managing this specific population are lacking.

In particular, little is known on which psychotherapies should be provided or which targets therapists should focus on, as well as how childhood trauma could explain the resistance to mood stabilizers.

The WHO World Health Organization estimates that a quarter of all adults report having been physically abused as a child, with childhood sexual abuse reported by one in five women and one in 13 men WHO Library Cataloguing-in-Publication Data In individuals suffering from severe mental disorders, childhood trauma is reported at a much higher rate.

Three previous reviews of the literature concerning childhood trauma in BD have been published within a short period of time Etain et al. Since a significant number of studies have been published since in this domain, an update of these reviews is particularly timely. Furthermore, issues regarding trauma as a whole, as compared with trauma subtypes emotional, physical and sexual trauma or gender, have emerged and will be discussed in this review.

Lastly, we will illustrate that, despite the growing volume of literature in this field, gaps between clinical and biological research and therapeutic implications are still wide. In , Fisher identified only six robust studies exploring childhood trauma in BD suggesting an association with childhood trauma. Since then, further studies have consolidated the level of proof Alvarez et al. Additionally, among trauma subtypes emotional, physical, and sexual abuses , only emotional abuse has a suggestive dose-effect with BD Alvarez et al.

All subscale scores are significantly higher in patients with BD compared to controls, apart from sexual abuse Watson et al. Janiri et al. Maniglio also reviews 20 studies, including young and adult patients with BD across 10 countries and three continents, concluding that, compared to healthy individuals, patients with BD report higher rates of child sexual abuse.

Therefore, childhood trauma in all its subcomponents appears to be highly associated with BD, although the specific role of each trauma subtype emotional, physical or sexual abuse remains a subject of debate. There are consistent indications that childhood traumatic events are associated with various severe clinical characteristics of BD, including an earlier onset of the illness Garno et al.

However, the quality of these studies has been reported to vary Daruy-Filho et al. Indeed, in a review of 18 studies performed by Daruy-Filho and colleagues , several limitations have been highlighted, including a lack of use of a structured clinical interview for diagnosis, a lack of use of a standardized trauma assessment, a low sample size less than patients and insufficient measures of current mood state as a potential confound in trauma assessment Daruy-Filho et al.

Three results appear consistently replicated across studies in BD: 1 the association between childhood trauma and an earlier age at onset; 2 the increased risk for suicide attempts; and 3 comorbid substance misuse. Daruy-Filho et al. We have demonstrated a dose effect of trauma exposure on the age at onset of BD Etain et al. A recent study of patients with BD from China reports associations between emotional abuse and neglect and an earlier age at onset Li et al.

Post et al. Therefore, exposure to early life stress seems to consistently lower the threshold for developing BD. Other replicated findings have been obtained for associations between childhood trauma, suicide attempts, and substance misuse in BD, following initial findings reviewed by Daruy-Filho et al. The association between childhood trauma and suicide attempt or substance misuse is probably not specific to BD.

Indeed, a year-long prospective study examining the development of illicit drug use from a birth cohort of New Zealand children finds that childhood sexual and physical abuse are the main predictors for illicit drug use at age 16—25 Fergusson et al.

This is consistent with the findings obtained by the NESARC, with associations between physical abuse and an increased risk for any substance use disorders Sugaya et al. We can therefore assume that childhood trauma elevates the risk of suicide attempt and substance misuse in BD, this probably being independent of psychiatric diagnoses. Several studies show that females with BD report childhood trauma more frequently than males Etain et al.

For instance, Etain and colleagues Etain et al. In healthy populations, childhood trauma is also more frequently reported by females than males, specifically for sexual abuse, while physical abuse is more frequently reported by healthy males Fisher et al. Additionally, greater associations between trauma and clinical characteristics in BD are reported in females.

This includes stronger associations to rapid cycling, early onset of illness, increased risk for at least one suicide attempt and more depressive episodes than in males with childhood trauma. Thus, the female gender may drive the association between childhood trauma and the clinical features of BD.

This in fact is investigated in the study by Etain et al. Another important issue concerns the subtypes of childhood trauma as compared to trauma in general that drive these effects on clinical characteristics.

Until recently, childhood physical and sexual abuses have been indicated as the strongest predictors of unfavorable clinical characteristics in BD. However, physical and sexual abuse are also the most frequently studied subtypes of childhood trauma, and only a few studies have paid any attention to emotional abuse or neglect Daruy-Filho et al.

Studies over the past few years may indicate evidence of emotional abuse as a more specific risk factor in BD Etain et al. Such studies have found a higher prevalence of emotional abuse in patients with BD compared to healthy controls, even after controlling for other types of abuse. A study by Martins et al. Moreover, patients with a history of emotional abuse have higher severity scores on all symptoms, including depression, hopelessness, suicidal ideation, anxiety, and impulsivity.

These data may suggest emotional abuse as a specific risk factor for certain psychiatric disorders possibly with anxious, depressive, and emotional core features.

Future studies should clarify the specific role of each trauma subtype. Trauma subtypes assessed by the CTQ Bernstein et al. One might postulate that childhood trauma is driving clinical outcomes psychiatric diagnoses or certain clinical features such as suicide attempts through non-specific dimensions of psychopathology e. Affective lability is suggested as a core feature of BD Aminoff et al. In BD, studies have found heightened affective lability in both manic and mixed episodes Henry et al.

A previous study has linked childhood trauma specifically emotional abuse to later affective lability in personality disorders and in BD Goodman et al. Furthermore, in an Emotion Recognition Task, patients with BD and childhood emotional neglect have a reduced performance in recognizing anger, compared to subjects without any trauma Russo et al.

Interestingly, childhood trauma is associated with increased amygdala activation van Harmelen et al. Childhood trauma is also a contributing factor to traits of aggression in BD Garno et al. This could be related to the effects of childhood trauma on the brain inhibitory control network Elton et al. BD patients also present deficits in cognitive functioning, particularly in areas of working memory, executive functioning, attention, and processing speed Bourne et al.

The mechanisms behind these impairments are poorly understood, and potentially based on both heritability and environmental susceptibility factors. Very few studies have investigated the potential role of childhood trauma on cognitive impairment in BD. A recent study of early BD demonstrates that patients with childhood trauma have poorer scores on IQ, attention, verbal memory and working memory Bucker et al.

Similar findings have also been reported in a more established stage of BD Savitz et al. The relationships between childhood trauma, dimensions of psychopathology, and cognition may help shed light on the clinical overlap or comorbidities between BD and other clinical entities such as those related to affect dysregulation, impulsivity and hostility borderline personality, suicide behaviors and substance misuse.

They could also lead to a greater vulnerability to other environmental stressors such as cannabis exposure or adulthood life events. A two-hits model of susceptibility has been proposed in psychosis, and could show relevance for BD Cannon et al. Further stressors during adolescence or young adulthood substance misuse, stressful events may serve to convert the vulnerability into a disorder.

In BD, the interaction between childhood trauma and susceptibility genes may predispose the individual to subtle changes in certain biological and physiopathological processes of the disorder. In this context, cannabis misuse during adolescence or later life events may act in and reveal this susceptibility or increasing the rate of mood recurrences.

The additive effects of childhood trauma and cannabis misuse have been demonstrated by increased rates for rapid cycling at an earlier age at onset and suicide attempt Aas et al. The possible mechanism behind the co-occurrence of childhood abuse and cannabis abuse could be related to their opposite effects on the hypothalamic—pituitary—adrenal HPA axis Heim et al. Cannabis and substance misuse have been linked to a reduction in HPA activity van Leeuwen et al. Several studies have examined the role of stressful adult life events and episode recurrence in BD Cohen et al.

The study by Cohen et al. Similarly, Swendsen et al. Research by Johnson and Miller observes that BD patients with severe negative life events in adulthood require a recovery period threefold longer in duration compared to those without adverse life events, as life events increase the risk of both first- and recurrent admissions in BD Kemner et al.

This could be mediated by changes in affect regulation, cognitive functioning or an increased impulsivity in association with maladaptive coping mechanisms. It is beyond the scope of this article to review all the relevant biological systems that could play a role in mediating the impact of childhood trauma on the risk of developing BD or a more severe form of the disorder. Some of them neuroplasticity, inflammation, circadian system or HPA axis could be much more central in BD.

A first mechanism linking childhood trauma to BD susceptibility relies on neuroplasticity mechanisms, in particular BDNF, which is a neurotrophic imperative for the growth and differentiation of neurons during brain development and the maintenance of neurons in adult life. Second, independently of psychiatric diagnoses, childhood trauma induces long-term modifications in inflammation processes Baumeister et al. Interestingly, some authors have proposed a potential interaction between an elevated BDNF and pro-inflammatory cytokine levels after trauma Bucker et al.

Sleep disturbances observed in BD Geoffroy et al. Indeed, in the general population, childhood adversity is a risk factor for adult sleep disorders Baiden et al. Since the circadian system modulates the biological responses to stressful environmental factors Landgraf et al. To date, only one study has explored such a hypothesis among patients with anxiety and depressive disorders and found that a high stress load in childhood was associated with alterations in several sleep parameters assessed with actigraphy Schafer and Bader Further research is also required regarding the impact of childhood trauma on the HPA axis functioning in BD.

A meta-analysis in schizophrenia and BD shows heightened levels of morning cortisol in BD Girshkin et al. As a potential future perspective, most of these biological systems possibly interact and converge to a high physical burden and reduced life expectancy in patients with BD Kessing et al. Indeed, a meta-analysis by Norman et al. Through long-lasting consequences on the alterations of immune-inflammatory markers, sleep parameters and HPA axis, childhood trauma might be associated with poor health conditions and, as such, this hypothesis deserves more attention.

Several mechanisms are likely to be involved in mediating the consequences of childhood trauma at the molecular level, with interactions between childhood trauma and genetic variants, epigenetics mechanisms and shortened telomere length being only a few. Exposure to childhood trauma is thought to interact with various susceptibility genes to increase the risk of BD, or to a more severe clinical expression of the expression of the disorder.

Miller et al. Benedetti et al.

Can sexual abuse cause bipolar disorder

Can sexual abuse cause bipolar disorder