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Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders

Published online by Cambridge University Press:  29 November 2016

M. Aas ,
C. Henry ,
F. Bellivier ,
M. Lajnef ,
S. Gard ,
J.-P. Kahn ,
T. V. Lagerberg ,
S. R. Aminoff ,
T. Bjella  and
M. Leboyer
...Show all authors
M. Aas*
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
C. Henry
Affiliation:
AP-HP, Hôpitaux Universitaires Henri Mondor, Pôle de Psychiatry, DHU Pepsy, Créteil, France Faculté de Médecine, Université Paris Est Créteil Val de Marne, Créteil, France Inserm, U955, Equipe Psychiatrie Translationnelle, Créteil, France Fondation Fondamental, Créteil, France ENBREC, European Network of Bipolar Research Expert Centres (ENBREC), Paris, France
F. Bellivier
Affiliation:
Fondation Fondamental, Créteil, France ENBREC, European Network of Bipolar Research Expert Centres (ENBREC), Paris, France AP-HP, Hôpital Fernand Widal, Pôle Addictologie-Toxicologie-Psychiatrie and Université Paris-7, and INSERM U1144, Paris, France
M. Lajnef
Affiliation:
Inserm, U955, Equipe Psychiatrie Translationnelle, Créteil, France
S. Gard
Affiliation:
Fondation Fondamental, Créteil, France Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Service de psychiatrie adulte, Bordeaux, France
J.-P. Kahn
Affiliation:
Fondation Fondamental, Créteil, France Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les NancyFrance
T. V. Lagerberg
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway
S. R. Aminoff
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway Department of Specialized Inpatient Treatment, Division of Mental Health Services, Akershus University Hospital, Norway
T. Bjella
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
M. Leboyer
Affiliation:
AP-HP, Hôpitaux Universitaires Henri Mondor, Pôle de Psychiatry, DHU Pepsy, Créteil, France Faculté de Médecine, Université Paris Est Créteil Val de Marne, Créteil, France Inserm, U955, Equipe Psychiatrie Translationnelle, Créteil, France Fondation Fondamental, Créteil, France ENBREC, European Network of Bipolar Research Expert Centres (ENBREC), Paris, France
O. A. Andreassen
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ENBREC, European Network of Bipolar Research Expert Centres (ENBREC), Paris, France
I. Melle
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Norway Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
B. Etain
Affiliation:
Fondation Fondamental, Créteil, France ENBREC, European Network of Bipolar Research Expert Centres (ENBREC), Paris, France AP-HP, Hôpital Fernand Widal, Pôle Addictologie-Toxicologie-Psychiatrie and Université Paris-7, and INSERM U1144, Paris, France
*
*Address for correspondence: M. Aas, Ph.D., Division of Mental Health and Addiction, NORMENT, KG Jebsen Psychosis Research Centre, TOP study group, Institute of Clinical Medicine, Bygg 49, Ullevål sykehus, PO Box 4956 Nydalen, 0424 Oslo, Norway. (Email: monica.aas@medisin.uio.no)
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Abstract

Background

Many studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD.

Method

A total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSS process macro.

Results

Using the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset.

Conclusions

Our data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.

Keywords

Bipolar disorderschildhood maltreatmentclinical features
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 5 , April 2017 , pp. 902 - 912
Copyright
Copyright © Cambridge University Press 2016 

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