Potential Impact of Childhood Abuse on Quality of Life During Mood-Stabilising Treatment in Individuals Living With Bipolar Disorder.

Overview

abstract

BACKGROUND: There is a lack of research examining whether childhood abuse affects the quality of life (QoL) of individuals living with bipolar disorder and its improvement over the course of treatment. METHODS: Data from the Clinical Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder were used to explore the associations between childhood abuse and multiple domains of QoL among 476 outpatients with bipolar disorder. Rates of change in QoL throughout treatment were explored with a series of Generalised Estimation Equations for repeated measures. RESULTS: At baseline, childhood abuse was related to poorer QoL in the domains of subjective feelings of wellbeing, social relationships and general activities-but not in physical health or leisure activities. Throughout treatment, participants with a history of childhood abuse reported significantly worse QoL in the same domains, than participants with no history of childhood abuse. Interestingly, exploratory analyses showed that participants with a history of childhood abuse and a current diagnosis of post-traumatic stress disorder (PTSD) had significantly worse QoL in all domains, than participants with no history of childhood abuse or diagnosis of PTSD. There were no significant differences between groups in change in QoL in any of the domains. CONCLUSION: This study comprehensively investigated the relationships between a history of childhood abuse and QoL among people with bipolar disorder who were receiving pharmacotherapy. Although the present findings need to be replicated, they suggest significant impairment in several domains of QoL associated with childhood abuse, which has service and treatment implications for trauma-informed care. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01331304.