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Assaultive trauma and illness course in psychotic bipolar disorder: findings from the suffolk county mental health project

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Abstract:

Neria Y, Bromet EJ, Carlson GA, Naz B. Assaultive trauma and illness course in psychotic bipolar disorder: findings from the suffolk county mental health project.

Acta Psychiatr Scand 2005: 111: 380–383. © Blackwell Munksgaard 2005. Objective: 

Little is known about the relationship of assaultive trauma to clinical and functional outcome in patients with bipolar disorder. Method: 

We assessed trauma histories in a cohort of 109 first-admission bipolar patients with psychosis using structured interviews and medical records. Assaultive trauma included rape, physical attacks, and physical threats. Outcome was assessed using standardized ratings. Results: 

Forty percent reported a history of assaultive trauma, mostly in childhood (≤16 years). Exposed patients were more symptomatic at each follow-up than unexposed. Sixteen percent of exposed patients remitted after one episode compared with 38.5% of the non-exposed. Patients exposed as adults were the most symptomatic at 6 months, while patients exposed in childhood were the most symptomatic at 24 months. Conclusion: 

Our findings supported the salient role of trauma history as a risk factor for poor course in severe bipolar disorder. Given the high prevalence of such exposure, clinical awareness in first-admission psychotic bipolar patients is critical.

Keywords: bipolar disorder; illness course; symptom severity; trauma

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2005.00530.x

Affiliations: 1: Department of Psychiatry and Department of Epidemiology, Columbia University and Anxiety Disorder Clinic, New York State Psychiatric Institute, New York 2: Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA

Publication date: May 1, 2005

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