Understanding the relationship between childhood abuse and affective symptoms in bipolar disorder: New insights from a network analysis

Anna L Wrobel; Megan Turner; Olivia M Dean; Michael Berk; Louisa G Sylvia; Michael E Thase; Thilo Deckersbach; Mauricio Tohen; Melvin G McInnis; James H Kocsis; Richard C Shelton; Michael J Ostacher; Dan V Iosifescu; Susan L McElroy; Alyna Turner; Andrew A Nierenberg

doi:10.1016/j.psychres.2024.116197

Understanding the relationship between childhood abuse and affective symptoms in bipolar disorder: New insights from a network analysis

Psychiatry Res. 2024 Sep 16:342:116197. doi: 10.1016/j.psychres.2024.116197. Online ahead of print.

Authors

Anna L Wrobel¹, Megan Turner², Olivia M Dean³, Michael Berk⁴, Louisa G Sylvia⁵, Michael E Thase⁶, Thilo Deckersbach⁷, Mauricio Tohen⁸, Melvin G McInnis⁹, James H Kocsis¹⁰, Richard C Shelton¹¹, Michael J Ostacher¹², Dan V Iosifescu¹³, Susan L McElroy¹⁴, Alyna Turner¹⁵, Andrew A Nierenberg⁵

Affiliations

¹ Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia; School of Psychology, Deakin University, Geelong, Victoria, Australia.
² School of Psychology, Deakin University, Geelong, Victoria, Australia.
³ Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia; Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia; Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
⁵ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
⁶ Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
⁷ University of Applied Sciences, DIPLOMA Hochschule, Bad Sooden-Allendorf, Germany.
⁸ University of New Mexico, Albuquerque, NM, USA.
⁹ University of Michigan, Ann Arbor, MI, USA.
¹⁰ Weill Cornell Medical College, New York, NY, USA.
¹¹ Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA.
¹² Department of Psychiatry, VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
¹³ Department of Psychiatry, NYU Grossman School of Medicine and Nathan Kline Institute, New York, NY, USA.
¹⁴ Lindner Center of HOPE, Mason, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹⁵ Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia. Electronic address: [email protected].

PMID: 39317000
DOI: 10.1016/j.psychres.2024.116197

Abstract

The impact of childhood abuse on the presentation of bipolar disorder could be further elucidated by comparing the networks of affective symptoms among individuals with and with no history of childhood abuse. Data from 476 participants in the Clinical Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study were used to fit several regularised Gaussian Graphical Models. Differences in the presentation of depressive and manic symptoms were uncovered: only among participants with a history of childhood abuse, inadequacy and pessimism were central symptoms in the network of depressive symptoms, while racing thoughts was an important symptom in the network of manic symptoms. Following network theory, focusing treatments at the symptom-level and on central symptoms - like inadequacy, pessimism, and racing thoughts - could be an effective approach for managing affective symptoms among the sizeable proportion of people with bipolar disorder who have experienced childhood abuse. This study contributes a thorough investigation of the networks of affective symptoms among participants with and with no history of childhood abuse, albeit limited by the use of a binary, self-report measure of childhood abuse, thereby emphasising the importance of assessing for childhood abuse and taking needed steps towards identifying novel targets for treating bipolar disorder.

Keywords: Depression; Mania; Mental health; Psychiatry; Serious mental illness; Symptom networks.