title: Childhood trauma and mixed episodes are associated with poor response to lithium in bipolar disorders.
abstract: OBJECTIVE
  Reliable predictors of response to lithium are still lacking in bipolar disorders (BDs). However, childhood trauma has been hypothesized to be associated with poor response to lithium.
  
  
  METHODS
  We included 148 patients with BD, euthymic when retrospectively and clinically assessed for response to lithium and childhood trauma using reliable scales.
  
  
  RESULTS
  According to the 'Alda scale', the sample consisted in 20.3% of excellent responders, 49.3% of partial responders and 30.4% of non-responders to lithium. A higher level of physical abuse significantly correlated with a lower level of response to lithium (P = 0.009). As compared to patients not exposed to any abuse, patients with at least two trauma abuses (emotional, physical or sexual) were more at risk of belonging to the non-responders group (OR = 4.91 95% CI (1.01-27.02)). Among investigated clinical variables, lifetime presence of mixed episodes and alcohol misuse were associated with non-response to lithium. Multivariate analyses demonstrated that physical abuse and mixed episodes were independently associated with poor response to lithium (P = 0.005 and P = 0.013 respectively).
  
  
  CONCLUSIONS
  Childhood physical abuse might be involved in a poor future response to lithium prophylaxis, this effect being independent of the association between clinical expression of BD and poor response to lithium.
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.|AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris cedex, France.|Inserm, U1144, Paris, France.|Fondation FondaMental, Créteil, France.|Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Etain
authors.affiliation: INSERM, U955, Psychiatrie Translationnelle, Créteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Lajnef
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.|AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris cedex, France.|Inserm, U1144, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Brichant-Petitjean
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.|AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris cedex, France.|Inserm, U1144, Paris, France.|Fondation FondaMental, Créteil, France.
authors.forename: P A
authors.initials: PA
authors.lastname: Geoffroy
authors.affiliation: Fondation FondaMental, Créteil, France.|INSERM, U955, Psychiatrie Translationnelle, Créteil, France.|Faculté de médecine, Université Paris Est, Créteil, France.|AP-HP, Hôpitaux Universitaires Albert Chenevier-Henri Mondor, DHU PePSY, Pôle de Psychiatrie, Créteil, France.|Institut Pasteur, Unité Perception et Mémoire, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Henry
authors.affiliation: Fondation FondaMental, Créteil, France.|Université Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Service de Psychiatrie Adulte, Pôle 3-4-7, Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Gard
authors.affiliation: Fondation FondaMental, Créteil, France.|Pôle de Psychiatrie et Psychologie Clinique (54G06), Centre Psychothérapique de Nancy, Laxou, France.|Université de Lorraine, Nancy, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Kahn
authors.affiliation: Fondation FondaMental, Créteil, France.|INSERM, U955, Psychiatrie Translationnelle, Créteil, France.|Faculté de médecine, Université Paris Est, Créteil, France.|AP-HP, Hôpitaux Universitaires Albert Chenevier-Henri Mondor, DHU PePSY, Pôle de Psychiatrie, Créteil, France.
authors.forename: M
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Young
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.|AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris cedex, France.|Inserm, U1144, Paris, France.|Fondation FondaMental, Créteil, France.
authors.forename: F
authors.initials: F
authors.lastname: Bellivier
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018020:Lithium Compounds
keywords: alcohol misuse; bipolar disorder; childhood trauma; lithium response; mixed episodes; physical abuse