Pretreatment and outcome correlates of past sexual and physical trauma in 118 bipolar I disorder patients with a first episode of psychotic mania.
OBJECTIVE
To assess the prevalence and correlates of childhood and adolescent sexual and/or physical abuse (SPA) in bipolar I disorder (BDI) patients treated for a first episode of psychotic mania.


METHODS
The Early Psychosis Prevention and Intervention Centre admitted 786 first-episode psychosis patients between 1998 and 2000. Data were collected from patients' files using a standardized questionnaire. A total of 704 files were available; 43 were excluded because of a nonpsychotic diagnosis at endpoint and 3 due to missing data regarding past stressful events. Among 658 patients with available data, 118 received a final diagnosis of BDI and were entered in this study.


RESULTS
A total of 80% of patients had been exposed to stressful life events during childhood and adolescence and 24.9% to SPA; in particular, 29.8% of female patients had been exposed to sexual abuse. Patients who were exposed to SPA had poorer premorbid functioning, higher rates of forensic history, were less likely to live with family during treatment period, and were more likely to disengage from treatment.


CONCLUSIONS
SPA is highly prevalent in BDI patients presenting with a first episode of psychotic mania; exposed patients have lower premorbid functional levels and poorer engagement with treatment. The context in which such traumas occur must be explored in order to determine whether early intervention strategies may contribute to diminish their prevalence. Specific psychological interventions must also be developed.
Conus
Philippe
P
Treatment and Early Intervention in Psychosis Program, Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, Prilly, Switzerland. philippe.conus@chuv.ch
Cotton
Sue
S
Schimmelmann
Benno G
BG
Berk
Michael
M
Daglas
Rothanthi
R
McGorry
Patrick D
PD
Lambert
Martin
M
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult