期刊
BIPOLAR DISORDERS
卷 17, 期 3, 页码 323-330出版社
WILEY
DOI: 10.1111/bdi.12268
关键词
comorbidities; early onset bipolar disorder; substance abuse
资金
- Sepracor
- Eli Lilly Co.
- Takeda Pharmaceuticals North America, Inc.
- H. Lundbeck A/S
- Sunovion Pharmaceuticals Inc.
- Netherlands Organization for Health Research and Development
- AstraZeneca
- Lundbeck
- Bristol-Myers Squibb
- Agency for Healthcare Research Quality (AHRQ)
- Cephalon
- Forest
- Marriott Foundation
- National Institute of Mental Health (NIMH)
- Orexigen Therapeutics, Inc.
- Shire
- Takeda Pharmaceutical Company Ltd
- Johnson & Johnson Pharmaceutical Research Development
- Pfizer
- Mayo Foundation
- Myriad
- National Institute of Alcohol Abuse and Alcoholism (NIAAA)
- NIMH
- Bial
- Hoffmann-LaRoche
- Janssen-Cilag
- Otsuka
- Sanofi-Aventis
- Servier
- Alkermes
- GlaxoSmithKline
- National Institute of Drug Abuse
- Orexigen
- Pfizer, Inc.
- European Union
- Stanley Medical Research Institute
- Wyeth
ObjectivesPhysical or sexual abuse in childhood is known to have an adverse effect on the course of bipolar disorder, but the impact of verbal abuse has not been well elucidated. MethodsWe examined the occurrence and frequency (never to frequently) of each type of abuse in childhood in 634 US adult outpatients (average age 40years). Patients gave informed consent and provided information about their age of onset and course of illness prior to study entry. ResultsVerbal abuse alone occurred in 24% of the patients. Similar to a history of physical or sexual abuse, a history of verbal abuse was related to an earlier age of onset of bipolar disorder and other poor prognosis characteristics, including anxiety and substance abuse comorbidity, rapid cycling, and a deteriorating illness course as reflected in ratings of increasing frequency or severity of mania and depression. ConclusionsA lasting adverse impact of the experience of verbal abuse in childhood is suggested by its relationship to an earlier age of onset of bipolar disorder, other poor prognosis factors, and a deteriorating course of illness. Verbal abuse is a common confound in comparison groups defined by a lack of physical or sexual abuse. Ameliorating the impact of verbal abuse on the unfolding course of bipolar disorder appears to be an important target of therapeutics and worthy of attempts at primary and secondary prophylaxis. Family-based treatments that focus on psychoeducation, enhancing intra-family communication, and coping skills may be particularly helpful.
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