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Affective instability, childhood trauma and major affective disorders
S Marwaha1, K Gordon-Smith2, M Broome3
1Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick Coventry, CV4 7AL UK; Affective Disorders Service (IPU 3-8), Caludon Centre, Coventry CV2 2TE, UK.
Journal of Affective Disorders
|November 30, 2015
Summary
Affective instability is higher in bipolar disorder I and II than major depressive disorder. Childhood trauma is linked to affective instability in bipolar I disorder, suggesting targeted interventions could improve outcomes.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Affective instability (AI) and childhood trauma are linked to poorer outcomes in mental illness.
- Limited evidence exists for this link in affective disorders.
- AI and childhood trauma are associated with worse outcomes.
Purpose of the Study:
- Compare AI levels across Bipolar I (BPI), Bipolar II (BPII), and Major Depressive Disorder Recurrent (MDDR).
- Examine the association between AI and childhood trauma within each diagnostic group.
Main Methods:
- Compared AI using the Affective Lability Scale (ALS) in DSM-IV BPI (n=923), BPII (n=363), and MDDR (n=207).
- Accounted for confounders and current mood.
- Used regression modeling to assess AI and childhood trauma association.
Main Results:
- ALS scores were highest in BPII, followed by BPI, then MDDR (p<0.05).
- In BPI, childhood abuse (any, physical) and childhood death of a friend correlated with higher ALS scores (p<0.05).
- No significant association between childhood trauma and AI was found in BPII or MDDR.
Conclusions:
- AI is a significant dimension in bipolar disorder, irrespective of mood state.
- Childhood trauma strongly links to AI in BPI, potentially mediating the exposure-disorder relationship.
- Interventions for AI in trauma-exposed BPI patients may alter the disorder's clinical course.
Keywords:
Affective instabilityAffective symptomsBipolar disorderDepressive disorderMood disordersStressful eventsMore Related Videos
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