title: Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder.
abstract: OBJECTIVE
  A role for childhood adversity in the development of numerous medical conditions in adults has been described in the general population, but has not been examined in patients with bipolar disorder who have multiple medical comorbidities which contribute to their premature mortality.
  
  
  METHODS
  More than 900 outpatients (average age 41) with bipolar disorder completed questionnaires that included information about the occurrence of verbal, physical, or sexual abuse in childhood and whether their parents had a mood or substance abuse disorder, or a history of suicidality. These factors were combined to form a total childhood adversity score, which was then related to one or more of 30 medical conditions patients rated as present or absent.
  
  
  RESULTS
  The child adversity score was significantly related to the total number of medical comorbidities a patient had (p<.001), as well as to 11 specific medical conditions that could be modeled in a logistic regression (p<.03). These included: asthma, arthritis, allergies, chronic fatigue syndrome, chronic menstrual irregularities, fibromyalgia, head injury (without loss of consciousness), hypertension, hypotension, irritable bowel syndrome, and migraine headaches.
  
  
  CONCLUSIONS
  The contribution of parental diagnosis to childhood adversity is highly inferential.
  
  
  CONCLUSIONS
  These data link childhood adversity to the later occurrence of multiple medical conditions in adult outpatients with bipolar disorder. Recognition of these relationships and early treatment intervention may help avert a more severe course of not only bipolar disorder but also of its prominent medical comorbidities and their combined adverse effects on patients'health, wellbeing, and longevity.
authors: Bipolar Collaborative Network, 5415 West Cedar Lane Suite 201B, Bethesda, MD 20814, USA. robert.post@speakeasy.net
authors: Robert M
authors: RM
authors: Post
authors: Lori L
authors: LL
authors: Altshuler
authors: Gabriele S
authors: GS
authors: Leverich
authors: Mark A
authors: MA
authors: Frye
authors: Trisha
authors: T
authors: Suppes
authors: Susan L
authors: SL
authors: McElroy
authors: Paul E
authors: PE
authors: Keck
authors: Willem A
authors: WA
authors: Nolen
authors: Ralph W
authors: RW
authors: Kupka
authors: Heinz
authors: H
authors: Grunze
authors: Mike
authors: M
authors: Rowe
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002649:Child Abuse; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires