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.2015 Mar;206(3):191-7.
doi: 10.1192/bjp.bp.114.152611. Epub 2015 Jan 22.

Adverse childhood events and psychosis in bipolar affective disorder

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Free article

Adverse childhood events and psychosis in bipolar affective disorder

Rachel Upthegrove et al. Br J Psychiatry.2015 Mar.
Free article

Abstract

Background: There has been increasing interest in the association between childhood trauma and psychosis. Proposals for potential mechanisms involved include affective dysregulation and cognitive appraisals of threat.

Aims: To establish if, within bipolar disorder, childhood events show a significant association with psychosis, and in particular with symptoms driven by dysregulation of mood or with a persecutory content.

Method: Data on lifetime-ever presence of psychotic symptoms were determined by detailed structured interview with case-note review (n = 2019). Childhood events were recorded using a self-report questionnaire and case-note information.

Results: There was no relationship between childhood events, or childhood abuse, and psychosis per se. Childhood events were not associated with an increased risk of persecutory or other delusions. Significant associations were found between childhood abuse and auditory hallucinations, strongest between sexual abuse and mood congruent or abusive voices. These relationships remain significant even after controlling for lifetime-ever cannabis misuse.

Conclusions: Within affective disorder, the relationship between childhood events and psychosis appears to be relatively symptom-specific. It is possible that the pathways leading to psychotic symptoms differ, with delusions and non-hallucinatory symptoms being influenced less by childhood or early environmental experience.

Royal College of Psychiatrists.

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Comment in

  • Hearing voices: are we getting the message?
    Khandaker GM, Dibben CR, Jones PB.Khandaker GM, et al.Br J Psychiatry. 2015 Sep;207(3):271-2. doi: 10.1192/bjp.207.3.271b.Br J Psychiatry. 2015.PMID:26329572Free PMC article.No abstract available.
  • Authors' reply.
    Upthegrove R, Jones I, Craddock N.Upthegrove R, et al.Br J Psychiatry. 2015 Sep;207(3):272. doi: 10.1192/bjp.207.3.272.Br J Psychiatry. 2015.PMID:26329573No abstract available.
  • Adverse childhood experiences and theory of mind.
    Raman S.Raman S.Br J Psychiatry. 2016 Jan;208(1):94. doi: 10.1192/bjp.208.1.94.Br J Psychiatry. 2016.PMID:26729844No abstract available.
  • Authors' reply.
    Upthegrove R, Jones I, Craddock N.Upthegrove R, et al.Br J Psychiatry. 2016 Jan;208(1):94. doi: 10.1192/bjp.208.1.94a.Br J Psychiatry. 2016.PMID:26729845No abstract available.

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