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Verbal abuse, like physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder
Author(s) -
Post Robert M,
Altshuler Lori L,
Kupka Ralph,
McElroy Susan L,
Frye Mark A,
Rowe Michael,
Leverich Gabriele S,
Grunze Heinz,
Suppes Trisha,
Keck Paul E,
Nolen Willem A
Publication year - 2015
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12268
Subject(s) - sexual abuse , bipolar disorder , psychiatry , mania , physical abuse , psychology , psychological abuse , clinical psychology , psychoeducation , child abuse , anxiety , poison control , medicine , suicide prevention , mood , medical emergency , intervention (counseling)
Objectives Physical or sexual abuse in childhood is known to have an adverse effect on the course of bipolar disorder, but the impact of verbal abuse has not been well elucidated. Methods We examined the occurrence and frequency (never to frequently) of each type of abuse in childhood in 634 US adult outpatients (average age 40 years). Patients gave informed consent and provided information about their age of onset and course of illness prior to study entry. Results Verbal abuse alone occurred in 24% of the patients. Similar to a history of physical or sexual abuse, a history of verbal abuse was related to an earlier age of onset of bipolar disorder and other poor prognosis characteristics, including anxiety and substance abuse comorbidity, rapid cycling, and a deteriorating illness course as reflected in ratings of increasing frequency or severity of mania and depression. Conclusions A lasting adverse impact of the experience of verbal abuse in childhood is suggested by its relationship to an earlier age of onset of bipolar disorder, other poor prognosis factors, and a deteriorating course of illness. Verbal abuse is a common confound in comparison groups defined by a lack of physical or sexual abuse. Ameliorating the impact of verbal abuse on the unfolding course of bipolar disorder appears to be an important target of therapeutics and worthy of attempts at primary and secondary prophylaxis. Family‐based treatments that focus on psychoeducation, enhancing intra‐family communication, and coping skills may be particularly helpful.