title: Physical and sexual abuse and early-onset bipolar disorder in youths receiving outpatient services: frequent, but not specific.
abstract: The objective of this study was to determine if physical and sexual abuse showed relationships to early-onset bipolar spectrum disorders (BPSD) consistent with findings from adult retrospective data. Participants (N = 829, M = 10.9 years old ± 3.4 SD, 60% male, 69% African American, and 18% with BPSD), primarily from a low socio-economic status, presented to an urban community mental health center and a university research center. Physical abuse was reported in 21%, sexual abuse in 20%, and both physical and sexual abuse in 11% of youths with BPSD. For youths without BPSD, physical abuse was reported in 16%, sexual abuse in 15%, and both physical and sexual abuse in 5% of youths. Among youth with BPSD, physical abuse was significantly associated with a worse global family environment, more severe depressive and manic symptoms, a greater number of sub-threshold manic/hypomanic symptoms, a greater likelihood of suicidality, a greater likelihood of being diagnosed with PTSD, and more self-reports of alcohol or drug use. Among youth with BPSD, sexual abuse was significantly associated with a worse global family environment, more severe manic symptoms, a greater number of sub-threshold manic/hypomanic symptoms, greater mood swings, more frequent episodes, more reports of past hospitalizations, and a greater number of current and past comorbid Axis I diagnoses. These findings suggest that if physical and/or sexual abuse is reported, clinicians should note that abuse appears to be related to increased severity of symptoms, substance use, greater co-morbidity, suicidality, and a worse family environment.
authors.affiliation: Department of Psychology, Western Washington University, MS 9172, 516 High Street, Bellingham, WA, 98225-9172, USA, tina.schudlich@wwu.edu.
authors.forename: Tina
authors.initials: T
authors.lastname: Du Rocher Schudlich
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.forename: Maria
authors.initials: M
authors.lastname: Martinez
authors.forename: Jennifer
authors.initials: J
authors.lastname: KogosYoungstrom
authors.forename: Kelly
authors.initials: K
authors.lastname: Scovil
authors.forename: Jody
authors.initials: J
authors.lastname: Ross
authors.forename: Norah C
authors.initials: NC
authors.lastname: Feeny
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002650:Child Abuse, Sexual / Q000523:psychology; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data