Is verbal abuse in childhood associated with earlier onset of bipolar disorder? Bipol Dis May 2015.

01.06.2015

Childhood adversity is associated with an earlier age of onset of bipolar disorder. They also tend to show a more difficult course. Sexual and physical abuse are the main childhood adversities studied in this regard. Verbal abuse is more common, but  the role of verbal abuse in isolation  has not been studied.

Would verbal abuse in childhood lead to early onset of bipolar disorder? Do they have  a more difficult course?

Post RM et al studied whether history of isolated verbal abuse in childhood would impact the age of onset of bipolar disorder. They examined the self reported verbal abuse by 634 adult bipolar outpatients in 4 US clinics.The question for verbal abuse was “ have you ever experienced mistreatment such as intimidation, threats, humiliation, or verbal abuse that caused you serious emotional harm? ” with further questions to clarify frequency and age at which it occurred.

Results

59% of the sample experienced verbal abuse in childhood ( along with other types of abuse) , with 24% reported having only verbal abuse in childhood.A significant effect was found for increased frequency of verbal abuse and earlier age of onset of bipolar disorder. Combination of sexual and verbal abuse lowered the age of onset of bipolar disorder ( as compared to  sexual abuse alone).The group with only verbal abuse (e.g., no physical or sexual abuse) showed significant increases in anxiety disorder comorbidity, drug abuse comorbidity, and rapid cycling, but not alcohol abuse.

Limitations: Subjective and retrospective data have the limitation that it is  subject to a variety of recall biases. However self reports are proven to be reliable methods in these contexts.

Comments: The association might be relevant to other psychiatric disorders as well. Relationship can be explained by psychological and biological mediating factors. For example, interpersonal violation ( =abuse) is associated with abnormalities in white matter tracts and size of hippocampus. Revising and restructuring   the childhood memories using psychotherapeutic techniques  is possible. This study also generate further understanding on what might help in preventing adult mental disorders.

Summary of the article

Verbal abuselike physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder. Post RM, Altshuler LL, Kupka R, McElroy SL, Frye MA, Rowe M, Leverich GS, Grunze H, Suppes T, Keck PE Jr, Nolen WA.

Bipolar Disord. 2015 May;17(3):323-30.

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