Prevalence and correlates of physical and sexual abuse in children and adolescents with bipolar disorder.
OBJECTIVE
Adult bipolar disorder (BP) has been associated with lifetime history of physical and sexual abuse. However, there are no reports of the prevalence of abuse in BP youth. The objective of this study was to examine the prevalence and correlates of physical and/or sexual abuse among youth with BP spectrum disorders.


METHODS
Four hundred forty-six youths, ages 7 to 17 years (12.7+/-3.2), meeting DSM-IV criteria for BP-I (n=260), BP-II (n=32) or operationalized definition of BP-NOS (n=154) were assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime version (K-SADS-PL). Abuse was ascertained using the K-SADS.


RESULTS
Twenty percent of the sample experienced physical and/or sexual abuse. The most robust correlates of any abuse history were living with a non-intact family (OR=2.6), lifetime history of posttraumatic stress disorder (PTSD) (OR=8.8), psychosis (OR=2.1), conduct disorder (CD) (OR=2.3), and first-degree family history of mood disorder (OR=2.2). After adjusting for confounding demographic factors, physical abuse was associated with longer duration of BP illness, non-intact family, PTSD, psychosis, and first-degree family history of mood disorder. Sexual abuse was associated with PTSD. Subjects with both types of abuse were older, with longer illness duration, non-intact family, and greater prevalence of PTSD and CD as compared with the non-abused group.


CONCLUSIONS
Retrospective data. Also, since this is a cross-sectional study, no inferences regarding causality can be made.


CONCLUSIONS
Sexual and/or physical abuse is common in youth with BP particularly in subjects with comorbid PTSD, psychosis, or CD. Prompt identification and treatment of these youth is warranted.
University of Pittsburgh Medical Center. Western Psychiatric Institute Clinic, United States. sromero@clinic.ub.es
Soledad
S
Romero
Boris
B
Birmaher
David
D
Axelson
Tina
T
Goldstein
Benjamin I
BI
Goldstein
Mary Kay
MK
Gill
Ana-Maria
AM
Iosif
Michael A
MA
Strober
Jeffrey
J
Hunt
Christianne
C
Esposito-Smythers
Neal D
ND
Ryan
Henrietta
H
Leonard
Martin
M
Keller
D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D000297:Psychology, Adolescent; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*