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Impact of childhood abuse on the clinical course of bipolar disorder

  • Jessica L. Garno (a1), Joseph F. Goldberg (a2), Paul Michael Ramirez (a3) and Barry A. Ritzler (a3)

Few investigations have examined the impact of childhood trauma, and domains of childhood abuse, on outcome in bipolar disorder.


To evaluate the prevalence and subtypes of childhood abuse reported by adult patients with bipolar disorder and relationshipto clinical outcome.


Prevalence rates of childhood abuse were retrospectively assessed and examined relative to illness complexity in a sample of 100 patients at an academic specialty centre for the treatment of bipolar disorder.


Histories of severe childhood abuse were identified in about half of the sample and were associated with early age at illness onset. Abuse subcategories were strongly inter-related. Severe emotional abuse was significantly associated with lifetime substance misuse comorbidity and past-year rapid cycling. Logistic regression indicated a significant association between lifetime suicide attempts and severe childhood sexual abuse. Multiple forms of abuse showed a graded increase in risk for both suicide attempts and rapid cycling.


Severe childhood trauma appears to have occurred in about half of patients with bipolar disorder, and may lead to more complex psychopathological manifestations.

Corresponding author
Dr Joseph F. Goldberg, The Zucker Hillside Hospital, 75–79 263rd Street, Glen Oaks, New York 11004, USA. Tel: 718 470 4134; fax: 718 343 1659; e-mail:
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Declaration of interest

None. Funding detailed in Acknowledgements.

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Impact of childhood abuse on the clinical course of bipolar disorder

  • Jessica L. Garno (a1), Joseph F. Goldberg (a2), Paul Michael Ramirez (a3) and Barry A. Ritzler (a3)
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Family history of bipolar

Judith A. Lewis, Retired
03 February 2005

Did your study take into consideration the family history of bipolar illness? Studies in the United States have indicated that bipolar disorder is a largely genetically inherited disorder. A child who has one parent with bipolar disorder has a 27% chance of being affected andthe possibility jumps to 50-75% when both parents are affected. Might theabuse or neglect be the result of having bipolar parents whose illness leads to inappropriate parenting? ... More

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