Influence of early childhood trauma on risk for bipolar disorder

Abstract The present chapter discusses that individuals with bipolar disorder are sensitive to environmental stressors, with emphasis on the role of childhood maltreatment. Childhood maltreatment, such as abuse and neglect, increases the risk for developing bipolar disorder. Furthermore, there are several lines of evidence suggesting that childhood maltreatment not only influences the development of bipolar disorder but may also modulate the phenotypic expression of the disorder. This modulation may reflect on early illness onset, more comorbidities, more hospitalizations, more suicide attempts, and lower treatment adherence. Therefore, a person diagnosed with bipolar disorder with a history of childhood maltreatment has a more severe form of bipolar disorder. The early onset of bipolar disorder due to maltreatment also reflects on early and different prodromal manifestations. These prodromal manifestations may occur during early childhood, and psychiatrists and pediatrics should be aware of this possibility. Identification of individuals with a history of child maltreatment should be incorporated into a clinical routine, since those individuals present a more chronic illness over time.