title: Adverse childhood events and psychosis in bipolar affective disorder.
abstract: BACKGROUND
  There has been increasing interest in the association between childhood trauma and psychosis. Proposals for potential mechanisms involved include affective dysregulation and cognitive appraisals of threat.
  
  
  OBJECTIVE
  To establish if, within bipolar disorder, childhood events show a significant association with psychosis, and in particular with symptoms driven by dysregulation of mood or with a persecutory content.
  
  
  METHODS
  Data on lifetime-ever presence of psychotic symptoms were determined by detailed structured interview with case-note review (n = 2019). Childhood events were recorded using a self-report questionnaire and case-note information.
  
  
  RESULTS
  There was no relationship between childhood events, or childhood abuse, and psychosis per se. Childhood events were not associated with an increased risk of persecutory or other delusions. Significant associations were found between childhood abuse and auditory hallucinations, strongest between sexual abuse and mood congruent or abusive voices. These relationships remain significant even after controlling for lifetime-ever cannabis misuse.
  
  
  CONCLUSIONS
  Within affective disorder, the relationship between childhood events and psychosis appears to be relatively symptom-specific. It is possible that the pathways leading to psychotic symptoms differ, with delusions and non-hallucinatory symptoms being influenced less by childhood or early environmental experience.
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Upthegrove
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Chard
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gordon-Smith
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Forty
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.affiliation: Rachel Upthegrove, MRCPsych, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham; Christine Chard, BMedSc, Lisa Jones, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham and Bipolar Disorder Research Network; Katherine Gordon-Smith, PhD, Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK; Liz Forty, PhD, Ian Jones, MRCPsych, PhD, Nick Craddock, FRCPsych, PhD, FMedSci, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Craddock
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D003702:Delusions / Q000150:complications / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications* / Q000523:psychology*; D012307:Risk Factors; D055815:Young Adult