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Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis
J E Palmier-Claus1, K Berry2, S Bucci2
1J. E. Palmier-Claus, PhD, ClinPsyD, Psychosis Research Unit, Greater Manchester West National Health Service Foundation Trust, Manchester, and Institute for Brain, Behaviour and Mental Health, University of Manchester; K. Berry, PhD, ClinPsyD, S. Bucci, DClinPsy, W. Mansell, DClinPsy, F. Varese, PhD, ClinPsyD, Section for Clinical and Health Psychology, University of Manchester, Manchester, UK Jasper.Palmier-Claus@manchester.ac.uk.
Background:
The relationship between childhood adversity and bipolar affective disorder remains unclear.
Aims:
To understand the size and significance of this effect through a statistical synthesis of reported research.
Method:
Search terms relating to childhood adversity and bipolar disorder were entered into Medline, EMBASE, PsycINFO and Web of Science. Eligible studies included a sample diagnosed with bipolar disorder, a comparison sample and a quantitative measure of childhood adversity.
Results:
In 19 eligible studies childhood adversity was 2.63 times (95% CI 2.00-3.47) more likely to have occurred in bipolar disorder compared with non-clinical controls. The effect of emotional abuse was particularly robust (OR = 4.04, 95% CI 3.12-5.22), but rates of adversity were similar to those in psychiatric controls.
Conclusions:
Childhood adversity is associated with bipolar disorder, which has implications for the treatment of this clinical group. Further prospective research could clarify temporal causality and explanatory mechanisms.
