Childhood trauma and bipolar spectrum: a population-based sample of young adults

Abstract Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis.

Factores sociodemográficos y eventos de vida tempranos asociados con la felicidad en adultos de Lima Metropolitana / Socio-demographic factors and early life events associated with happiness in adults of Metropolitan Lima

RESUMEN Objetivos: Estimar los factores sociodemográficos y eventos de vida tempranos asociados con la feli cidad en adultos de Lima Metropolitana. Materiales y métodos: Se realizó un análisis secundario del Estudio Epidemiológico de Salud Mental de Lima Metropolitana 2012, el cual utilizó los instrumentos de índice de calidad de vida, la versión breve y modificada del EMBU, un cuestionario de eventos adver sos tempranos, un índice de felicidad construido a partir del ítem único sobre felicidad de Andrews y la escala de satisfacción con la vida. Se realizaron análisis multivariados ajustados. Resultados: La felicidad se asoció con el sexo, estado civil, pobreza y nivel de instrucción. Los estilos de crianza asociados con menor felicidad fueron: las conductas de rechazo y las actitudes machistas, y con mayor felicidad: el calor emocional. No se encontró asociación con prácticas de crianza de sobreprotección o favoritismo. Como eventos adversos tempranos se asociaron significativamente: discusiones dentro de la familia, padre con problemas de alcohol, ausencia paterna, conductas de amenazas o chantaje emocional. Conclusiones: Los hallazgos resaltan la importancia de desarrollar programas intensivos en los primeros años de vida que estimulen estilos de crianza y ambientes de desarrollo saludables.

ABSTRACT Objectives: To estimate socio-demographic factors and early life events associated with happiness in adults in metropolitan Lima. Materials and methods: A secondary analysis was carried out on the Epi demiological Study of Mental Health of Metropolitan Lima 2012. The instruments used were the Quality of Life Index; a brief and modified version of the EMBU; a questionnaire of early adverse events; a Hap piness Index built from Andrews' single item of Happiness and the Life Satisfaction Scale. Adjusted mul tivariate analyses were performed. Results: Happiness was significantly associated with gender, marital status, poverty, and level of education. Parenting styles associated significantly with less happiness were: behaviors of rejection and sexist attitudes; and with higher happiness: emotional warmth. No associa tion was found with overprotection or favoritism breeding practices. Early adverse events significantly associated with lower happiness were discussions within the family, father with problems of alcohol, parental absence, behaviors of emotional blackmail or threats. Conclusions: This study highlights the importance of developing intensive programs in the first years of life that promote parenting styles and healthy development environments.

Depresión adulta y experiencias infantiles adversas: evidencia de un subtipo depresivo complejo en consultantes de la atención primaria en Chile / Association between adverse childhood experiences with depression in adults consulting in primary care

Background: Traumatic experiences during childhood may influence the development of mental disorders during adulthood. Aim: To determine clinical and psychosocial variables that are associated with a higher frequency of adverse childhood experiences (ACE) in patients who consult for depression in Primary Health Care clinics in Chile. Material and Methods: A socio-demographic interview, the mini international neuropsychiatric interview (MINI), a screening for ACE, a questionnaire for partner violence (PV), the Life Experiences Survey (LES) and the Hamilton Rating Scale for Depression (HRDS) were applied to 394 patients with major depression (87% women). Results: Eighty two percent of patients had experienced at least one ACE and 43% of them reported three or more. Positive correlations were observed between the number of ACE and severity of depressive symptoms (r = 0.19; p < 0.01), psychiatric comorbidities (r = 0.23; p < 0.01), partner violence events (r = 0.31; p < 0.01), vital stressful events (r = 0.12; p < 0.01), number of depressive episodes (r = 0.16; p < 0.01), duration of the longer depressive episode (r = 0.12; p < 0.05) and suicidal tendency according to HDRS (r = 0.16; p < 0.01). An inverse correlation was observed between frequency of ACE and age at the first depressive episode (r = -0.12; p < 0.05). Conclusions: These data are consistent with the hypothesis that early trauma is associated with more severe and complex depressive episodes during adulthood.