Association of Childhood Trauma, Social Support, Cognition, and Suicidality in Females with Bipolar Disorder

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2024 Apr 2

PMID 38566037

Authors

Min Yang

Jiaxin Li

Yaqian Fu

Guotao Wang

Minghui Liu

Jindong Chen

Jieyu Liu

Affiliations

Soon will be listed here.

Abstract

Background: Bipolar disorder (BD) is a severe mental disorder with heavy disease burden. Females with BD are special populations who suffer a lot from childhood trauma, social support, cognitive deficits, and suicidality. In this study, the relationship among childhood trauma, social support, and clinical symptoms of BD was investigated and the risk factors for suicidality were explored in female patients with BD.

Methods: This study included 57 drug-naive female BD patients, 64 female BD patients with long-term medication, and 50 age-matched female healthy controls. Childhood trauma, social support, clinical symptoms, cognition, and suicidality (suicide ideation, suicide plan, suicide attempt, suicide frequency) were measured with scales.

Results: Compared with healthy controls, females with BD showed higher levels of childhood trauma and suicidality, and lower levels of social support and cognitive deficits. In the drug-naïve BD group, social support mediated the relationship between childhood trauma and insomnia symptoms (indirect effect: ab = 0.025). In the BD with long-term medication group, mania symptom was associated with suicide plan (OR = 1.127, p = 0.030), childhood trauma was associated with suicide attempt (OR = 1.088, p = 0.018), and years of education (OR = 0.773, p = 0.028), childhood trauma (OR = 1.059, p = 0.009), and delayed memory (OR= 1.091, p= 0.016) was associated with suicide frequency (OR = 1.091, p = 0.016).

Conclusions: This study provides initial evidence that social support partially explains the relationship between childhood trauma and clinical symptoms in females with BD. Additionally, mania symptoms, childhood trauma, and delayed memory were risk factors for suicidality. Interventions providing social support and improving cognitive function may be beneficial for females with BD who are exposed to childhood trauma and with high suicide risk.

References

Nikolitch K, Saraf G, Solmi M, Kroenke K, Fiedorowicz J . Fire and Darkness: On the Assessment and Management of Bipolar Disorder. Med Clin North Am. 2022; 107(1):31-60. DOI: 10.1016/j.mcna.2022.04.002. View

Miklowitz D, Otto M, Frank E, Reilly-Harrington N, Kogan J, Sachs G . Intensive psychosocial intervention enhances functioning in patients with bipolar depression: results from a 9-month randomized controlled trial. Am J Psychiatry. 2007; 164(9):1340-7. PMC: 3579578. DOI: 10.1176/appi.ajp.2007.07020311. View

Swartz H, Levenson J, Frank E . Psychotherapy for Bipolar II Disorder: The Role of Interpersonal and Social Rhythm Therapy. Prof Psychol Res Pr. 2015; 43(2):145-153. PMC: 4657867. DOI: 10.1037/a0027671. View

Rhee T, Gillissie E, Nierenberg A, McIntyre R . Association of current and remitted bipolar disorders with health-related quality of life: Findings from a nationally representative sample in the US. J Affect Disord. 2022; 321:33-40. DOI: 10.1016/j.jad.2022.10.025. View

Kanner A, Saporta A, Kim D, Barry J, Altalib H, Omotola H . Mood and Anxiety Disorders and Suicidality in Patients With Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity. Neurology. 2022; 100(11):e1123-e1134. PMC: 10074468. DOI: 10.1212/WNL.0000000000201671. View

Van Rheenen T, Rossell S . Objective and subjective psychosocial functioning in bipolar disorder: an investigation of the relative importance of neurocognition, social cognition and emotion regulation. J Affect Disord. 2014; 162:134-41. DOI: 10.1016/j.jad.2014.03.043. View

Tian X, Liao Z, Yi L, Tang L, Chen G, Herrera M . Efficacy and mechanisms of 4-week MBSR on psychological distress in lung cancer patients: A single-center, single-blind, longitudinal, randomized controlled trial. Asia Pac J Oncol Nurs. 2022; 10(1):100151. PMC: 9667193. DOI: 10.1016/j.apjon.2022.100151. View

Oviedo D, Pinzon M, Rodriguez-Arana S, Tratner A, Pauli-Quiros E, Chavarria C . Psychosocial response to the COVID-19 pandemic in Panama. Front Public Health. 2022; 10:919818. PMC: 9399740. DOI: 10.3389/fpubh.2022.919818. View

Nierenberg A, Agustini B, Kohler-Forsberg O, Cusin C, Katz D, Sylvia L . Diagnosis and Treatment of Bipolar Disorder: A Review. JAMA. 2023; 330(14):1370-1380. DOI: 10.1001/jama.2023.18588. View

10.

Xu X, Xiang H, Qiu Y, Teng Z, Li S, Huang J . Sex differences in cognitive function of first-diagnosed and drug-naïve patients with bipolar disorder. J Affect Disord. 2021; 295:431-437. DOI: 10.1016/j.jad.2021.08.125. View

11.

Brindle R, Cribbet M, Samuelsson L, Gao C, Frank E, Krafty R . The Relationship Between Childhood Trauma and Poor Sleep Health in Adulthood. Psychosom Med. 2017; 80(2):200-207. PMC: 5794533. DOI: 10.1097/PSY.0000000000000542. View

12.

Taylor S, Klein L, Lewis B, Gruenewald T, Gurung R, Updegraff J . Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight. Psychol Rev. 2000; 107(3):411-29. DOI: 10.1037/0033-295x.107.3.411. View

13.

Sitges-Macia E, Bonete-Lopez B, Sanchez-Cabaco A, Oltra-Cucarella J . Effects of e-Health Training and Social Support Interventions for Informal Caregivers of People with Dementia-A Narrative Review. Int J Environ Res Public Health. 2021; 18(15). PMC: 8345641. DOI: 10.3390/ijerph18157728. View

14.

Hamilton M . The assessment of anxiety states by rating. Br J Med Psychol. 1959; 32(1):50-5. DOI: 10.1111/j.2044-8341.1959.tb00467.x. View

15.

Wrobel A, Kohler-Forsberg O, Sylvia L, Russell S, Dean O, Cotton S . Childhood trauma and treatment outcomes during mood-stabilising treatment with lithium or quetiapine among outpatients with bipolar disorder. Acta Psychiatr Scand. 2022; 145(6):615-627. PMC: 9310642. DOI: 10.1111/acps.13420. View

16.

COBB S . Presidential Address-1976. Social support as a moderator of life stress. Psychosom Med. 1976; 38(5):300-14. DOI: 10.1097/00006842-197609000-00003. View

17.

Gilbert A, Garno J, Braga R, Shaya Y, Goldberg T, Malhotra A . Clinical and cognitive correlates of suicide attempts in bipolar disorder: is suicide predictable?. J Clin Psychiatry. 2011; 72(8):1027-33. PMC: 4035109. DOI: 10.4088/JCP.10m06410. View

18.

Doran S, Carey D, Knight S, Meaney J, Kenny R, De Looze C . Relationship between hippocampal subfield volumes and cognitive decline in healthy subjects. Front Aging Neurosci. 2023; 15:1284619. PMC: 10733466. DOI: 10.3389/fnagi.2023.1284619. View

19.

Stewart R, Patel T, McDermott K, Cougle J . Functional and structural social support in DSM-5 mood and anxiety disorders: A population-based study. J Affect Disord. 2022; 308:528-534. DOI: 10.1016/j.jad.2022.04.026. View

20.

Bedrov A, Gable S . Thriving together: the benefits of women's social ties for physical, psychological and relationship health. Philos Trans R Soc Lond B Biol Sci. 2022; 378(1868):20210441. PMC: 9703221. DOI: 10.1098/rstb.2021.0441. View