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Affective instability, childhood trauma and major affective disorders
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Marwaha, Steven, Gordon-Smith, K., Broome, Matthew R., Briley, P.M., Perry, A., Forty, L., Craddock, N., Jones, I. and Jones, L. (2015) Affective instability, childhood trauma and major affective disorders. Journal of Affective Disorders, 190 . pp. 764-771. doi:10.1016/j.jad.2015.11.024
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WRAP_Affective instability (JAD_2015_1064) -accepted JAD 15 11 15.pdf - Accepted Version - Requires a PDF viewer. Download (730Kb) | Preview |
Official URL: http://dx.doi.org/10.1016/j.jad.2015.11.024
Abstract
Background
Affective instability (AI), childhood trauma, and mental illness are linked, but evidence in affective disorders is limited, despite both AI and childhood trauma being associated with poorer outcomes. Aims were to compare AI levels in bipolar disorder I (BPI) and II (BPII), and major depressive disorder recurrent (MDDR), and to examine the association of AI and childhood trauma within each diagnostic group.
Methods
AI, measured using the Affective Lability Scale (ALS), was compared between people with DSM-IV BPI (n=923), BPII (n=363) and MDDR (n=207) accounting for confounders and current mood. Regression modelling was used to examine the association between AI and childhood traumas in each diagnostic group.
Results
ALS scores in descending order were BPII, BPI, MDDR, and differences between groups were significant (p<0.05). Within the BPI group any childhood abuse (p=0.021), childhood physical abuse (p=0.003) and the death of a close friend in childhood (p=0.002) were significantly associated with higher ALS score but no association was found between childhood trauma and AI in BPII and MDDR.
Limitations
The ALS is a self-report scale and is subject to retrospective recall bias.
Conclusions
AI is an important dimension in bipolar disorder independent of current mood state. There is a strong link between childhood traumatic events and AI levels in BPI and this may be one way in which exposure and disorder are linked. Clinical interventions targeting AI in people who have suffered significant childhood trauma could potentially change the clinical course of bipolar disorder.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Affective disorders, Affective disorders in children, Manic-depressive illness, Child psychiatry, Mental illness -- Prevention, Psychic trauma in children, Depression, Mental, Depression in children, Pediatric psychopharmacology | ||||||||
| Journal or Publication Title: | Journal of Affective Disorders | ||||||||
| Publisher: | Elsevier Science BV | ||||||||
| ISSN: | 0165-0327 | ||||||||
| Official Date: | 17 November 2015 | ||||||||
| Dates: |
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| Volume: | 190 | ||||||||
| Page Range: | pp. 764-771 | ||||||||
| DOI: | 10.1016/j.jad.2015.11.024 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access |
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