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Childhood maltreatment linked to later medical morbidity among bipolar disorder patients

21 Nov 2018

Adults with bipolar disorder who had been maltreated as a child are more likely to have a medical illness than adults with unipolar depression who have had the same experience, according to a study.

The study included 248 adults with recurrent unipolar depression, 72 with bipolar disorder and 354 psychiatrically healthy controls. All participants completed the Childhood Trauma Questionnaire and received a validated medical history interview.

Individuals with bipolar disorder had significantly longer illness duration and more depressive episodes compared with their counterparts with unipolar depression. In the entire cohort, commonly reported medical conditions were hypertension, arthritis and asthma.

Childhood maltreatment was more prevalent in the bipolar and unipolar groups than in the control group. Frequently reported forms of maltreatment were emotional abuse and neglect. Any type of abuse showed a moderate correlation with any type of neglect in the whole sample.

Childhood maltreatment of any form was significantly associated with medical burden in bipolar disorder but not in unipolar depression or in controls. This association showed a dose-response pattern, such that participants with bipolar disorder and a history of at least two forms of childhood maltreatment had the highest odds of developing a medical illness relative to those without such history or those who reported having experienced only one form.

No significant dose-response patterns were observed in the unipolar depression or control group.

The present data show the high medical morbidity in mood disorders, especially bipolar disorder, underscoring the need for regular physical health assessments in affected individuals, researchers said. Such assessments will facilitate earlier detection of medical illness and timely implementation of prevention and intervention strategies, improving the prognosis and reducing the morbidity and mortality attributed to physical illnesses.

Additional investigation is required to identify a subgroup of people with mood disorders and a history of maltreatment, who may be especially vulnerable to worse clinical course and poor physical health, researchers added.

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In patients with type 2 diabetes, obesity may be protective against vision-threatening diabetic retinopathy, a recent Korea study has shown.
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