The effect of childhood trauma on sleep quality and functionality in patients with bipolar disorder-I

Abstract

Childhood trauma in bipolar patients affect multiple clinical variables. Sleep is a parameter affecting prognosis and functionality in bipolar patients. In this study; we aim to evaluate the effect of childhood trauma on sleep and functionality. The study included a healthy control group (n=50) and a total of 100 patients diagnosed with BAD-I according to DSM-5 diagnostic criteria who were admitted to our hospital between January 12, 2021, and June 30, 2021. Sociodemographic data form, Pittsburg Sleep Quality Index (PSQI), Childhood Psychiatric Trauma Scale (CTQ), and Bipolar Disorder Functioning Scale (BDFS) scales were applied to the patient and control groups.Compared to the control group, in the patient group; There was a statistically significant increase in the CTQ total score, emotional abuse, emotional neglect, and sexual abuse subscale scores; The sub-scores for work, emotional functionality, mental functionality, stigmatization, introversion, social participation, daily activities and hobbies, and BDFS total scores were found to be statistically lower (p< 0.05). Because of the correlation between the scale scores, there was a negative correlation between the PSQI total score and the BDFS total score. Childhood traumas and sleep problems are more common in patients with bipolar disorder than in healthy controls. In addition, childhood traumas may cause deterioration in bipolar functionality scores such as emotional functionality and introversion in bipolar patients.

Keywords

• chıldhood trauma
• bipolar disorder
• sleep
• functionality

References

1. Garno JL, Goldberg JF, Ramirez PM, Ritzler BA: Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry 2005; 186: 121–5.
2. Giglio LM, Andreazza AC, Andersen M, Ceresér KM, Walz JC, Sterz L et al.: Sleep in bipolar patients. Sleep Breath 2009; 13: 169-173.
3. Lavie, P: Sleep disturbances in the wake of traumatic events. New England Journal of Medicine 2001; 345(25), 1825–1832.
4. E Aubert, I Jaussent, E Olié, D Ducasse, J M Azorin, F Bellivier, et al.: Effect of early trauma on the sleep quality of euthymic bipolar patients. J Affect Disord 2016;206:261-267.
5. McEwen BS: Effects of Stress on the Developing Brain. Cerebrum 2011; 2011: 14.
6. Andersen SL, Teicher MH: Stress, sensitive periods and maturational events in adolescent depression. Trends Neurosci 2008;31(4):183-91.
7. Brown GR, Anderson B: Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry 1991; 148, 55–61.
8. Heim C, Nemeroff CB: The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies. Biological Psychiatry 2001; 49, 1023–1039.

9. Stain HJ, Brønnick K, Hegelstad WTW, Joa I, Johannessen JO, Langeveld J et al.: Impact of interpersonal trauma on the social functioning of adults with first-episode psychosis. Schizophr Bull 2014;40(6):1491-8.
10. Cotter J, Kaess M, Yung AR: Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literatüre. Ir J Psychol Med 2015;32(1):21-30.
11. Hjelseng IG, Vaskinn A, Ueland T, Lunding SH, Reponen AJ, Steen NE et al.: Childhood trauma is associated with poorer social functioning in severe mental disorders both during an active illness phase and in remission. Schizophr Res 2022;243:241-246.
12. Harvey AG: Sleep and circadian rhythms in bipolar disorder: seeking synchrony, harmony, and regulation. Am J Psychiatry 2008;165(7):820-9.
13. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al.: Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003; 27:169–90.
14. Sar V, Ozturk E, Ikikardes E: Validity and reliability of the Turkish version of Childhood Trauma Questionnaire. Turk Klin Tip Bilim Derg 2012; 32:4.
15. Buysse DJ, Reynolds CF, Monk TH: The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28:193-213.
16. Agargün MY, Kara H, Anlar O: Pittsburgh Uyku Kalitesi İndeksi’nin Geçerliği ve Güvenirliği. Turk Psikiyatri Derg 1996; 7: 107-11.
17. Aydemir Ö, Eren İ, Savaş H, Oguzhanoglu NK, Koçal N, Özgüven HD, et al.: Bipolar Bozuklukta İşlevsellik Ölçeğinin geliştirilmesi, güvenilirlik ve geçerliliği. Türk Psikiyatri Dergisi 2007; 18(4):344-352.
18. Rocha PM, Neves SF, Corrêa H: Significant sleep disturbances in euthymic bipolar patients. Compr Psychiatry 2013;54(7):1003-8.
19. Keskin N, Tamam L, Ozpoyraz N: Assessment of sleep quality in bipolar euthymic patients. Compr Psychiatry 2018; 80: 116-125.
20. Agnew-Blais J, Danese A: Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry 2016; 3(4):342-9.
21. Koskenvuo K, Hublin C, Partinen M, Paunio T, Koskenvuo M: Childhood adversities and quality of sleep in adulthood: A population-based study of 26,000 Finns. Sleep Med 2010;11(1):17-22.
22. Laskemoen JK, Aas M, Vaskinn A, Berg AO, Lunding SH, Barrett EA et al. Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders. Psychol Med. 2021;51(14):2337-2346.
23. Gruber J, Harvey AG, Wang PW, Brooks JO, Thase ME, Sachs GS, et al.: Sleep functioning in relation to mood, function, and quality of life at entry to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). J Affect Disord 2009;114(1-3):41-9.
24. Bradley AJ, Anderson KN, Gallagher P, McAllister-Williams RH: The association between sleep and cognitive abnormalities in bipolar disorder. Psychol Med 2020; 50: 125-32.
25. Quidé Y, Cohen-Woods S, O’Reilly N, Carr VJ, Elzinga BM, Green MJ: Schizotypal personality traits and social cognition are associated with childhood trauma exposure. Br J Clin Psychol 2018; 57(4): 397–419.
26. Lebovitz JG, Millett CE, Shanahan M, Levy-Carrick NM, Burdick KE: The impact of lifetime interpersonal and intentional trauma on cognition and vulnerabilityto psychosis in bipolar disorder. BJPsych Open 2021; 7(5): 164.
27. Dualibe AL, Osório FL: Bipolar Disorder and Early Emotional Trauma: A Critical Literature Review on Indicators of Prevalence Rates and Clinical Outcomes. Harv Rev Psychiatry 2017;25(5):198-208.
28. Antelo E, Saldaña O, Rodríguez-Carballeira A: The impact of group psychological abuse on distress: the mediating role of social functioning and resilience. Eur J Psychotraumatol 2021;12(1):1954776.
29. Erten E, Uney AF, Saatçioğlu Ö, Özdemir A, Fıstıkçı N, Çakmak D: Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar I disorder. J Affect Disord 2014;162:107-13.
30. Savitz JB, van der Merwe L, Stein DJ, Solms M, Ramesar RS: Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma. Bipolar Disord 2008;10(4):479-94.