title: Childhood maltreatment and comorbid anxiety in people with bipolar disorder.
abstract: BACKGROUND
  Comorbid anxiety disorders and a history of childhood maltreatment are important determinants of outcome in bipolar disorder, but the relationship between these two factors is unclear.
  
  
  METHODS
  In 174 outpatients with bipolar disorder, we assessed history of childhood maltreatment with the Childhood Trauma Questionnaire (CTQ) and lifetime diagnosis of anxiety disorders with the M.I.N.I. International Neuropsychiatric Interview. We used ordinary logistic regressions to test associations between childhood maltreatment and the number of comorbid anxiety disorders, controlling for age, sex and the type of bipolar disorder.
  
  
  RESULTS
  Ninety (51.7%) participants had no anxiety disorder, 50 (28.7%) had one anxiety disorder and 34 (19.5%) had two or more anxiety disorders. Childhood maltreatment, indexed by a higher CTQ total score, was associated with more lifetime anxiety disorders (OR=1.5; 95% CI=1.01 to 2.14; p=0.04). Of the CTQ subscales, emotional abuse (OR=1.68; 95% CI=1.13 to 2.49; p=0.01) and physical abuse (OR=1.43; 95% CI=1.02 to 2.01; p=0.04) were associated with anxiety disorders. Of the anxiety disorders, panic disorder was most strongly associated with childhood maltreatment (OR=2.27; 95% CI=1.28 to 4.02; p=0.01).
  
  
  CONCLUSIONS
  The study is limited by a moderate sample size and the retrospective assessment of childhood maltreatment.
  
  
  CONCLUSIONS
  Exposure to maltreatment in childhood is associated with comorbid anxiety disorders among individuals living with bipolar disorder. Bipolar disorder with comorbid anxiety may constitute a separate aetiological type with a greater contribution of early environment.
authors.affiliation: Dalhousie University Department of Psychiatry, Halifax, NS, Canada; Nova Scotia Health Authority, Halifax, NS, Canada. Electronic address: barbara.pavlova@dal.ca.
authors.forename: Barbara
authors.initials: B
authors.lastname: Pavlova
authors.affiliation: University Hospitals of Geneva, Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Geneva, Switzerland; University of Geneva, Department of Psychiatry, Geneva, Switzerland.
authors.forename: Nader
authors.initials: N
authors.lastname: Perroud
authors.affiliation: University Hospitals of Geneva, Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Geneva, Switzerland.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cordera
authors.affiliation: Dalhousie University Department of Psychiatry, Halifax, NS, Canada; Nova Scotia Health Authority, Halifax, NS, Canada.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.affiliation: University Hospitals of Geneva, Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Geneva, Switzerland; University of Geneva, Department of Psychiatry, Geneva, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Dayer
authors.affiliation: University Hospitals of Geneva, Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Geneva, Switzerland; University of Geneva, Department of Psychiatry, Geneva, Switzerland.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Aubry
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Anxiety disorders; Bipolar disorder; Childhood maltreatment