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Assaultive trauma and illness course in psychotic bipolar disorder: findings from the suffolk county mental health project
Author(s) -
Neria Y.,
Bromet E. J.,
Carlson G. A.,
Naz B.
Publication year - 2005
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.2005.00530.x
Subject(s) - bipolar disorder , psychiatry , medicine , psychosis , cohort , poison control , medical record , pediatrics , psychology , emergency medicine , surgery , lithium (medication)
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.