Interpersonal Trauma and Depression Severity Among Individuals With Bipolar Disorder: Findings From the Prechter Longitudinal Study of Bipolar Disorder

Anna L. Wrobel, PhD^a,b ; Samantha E. Russell, BHealth&MedSc(Hons)^a ; Anuradhi Jayasinghe, MA^b,c ; Mojtaba Lotfaliany, PhD^a ; Alyna Turner, PhD^a,d ; Olivia M. Dean, PhD^a,e ; Sue M. Cotton, PhD^b,f ; Claudia Diaz-Byrd, MS^g ; Anastasia K. Yocum, PhD^g ; Elizabeth R. Duval, PhD^g ; Tobin J. Ehrlich, PhD^g ; David F. Marshall, PhD^g ; Michael Berk, MD^a,b,e,f,h ; Melvin G. McInnis, MD^g

J Clin Psychiatry 2023;84(3):22m14434

ABSTRACT

Background: Experiences of interpersonal trauma, both in childhood and in adulthood, can affect the trajectory of bipolar disorder (BD). However, the degree to which childhood and/or adult trauma impacts the longitudinal trajectory of depression severity among individuals with BD actively receiving treatment remains unclear.

Methods: The effects of childhood trauma (Childhood Trauma Questionnaire) and adult trauma (Life Events Checklist) on depression severity (Hamilton Depression Rating Scale) were investigated in a treatment-receiving subsample with BD (DSM-IV) of the Prechter Longitudinal Study of Bipolar Disorder (2005–present). A mixed-effects linear regression model was used to assess the trajectory of depression severity over 4 years.

Results: Depression severity was evaluated in 360 participants, of whom 267 (74.8%) reported a history of interpersonal trauma. A history of childhood trauma alone (n = 110) and childhood and adult trauma combined (n = 108)—but not adult trauma alone (n = 49) —were associated with greater depression severity at the 2-year and 6-year follow-up assessments. However, the trajectory of depression severity (ie, change over time) was similar between participants with a history of childhood trauma, those with a history of adult trauma, and those with no history of interpersonal trauma. Interestingly, participants with a history of both types of trauma showed more improvement in depression severity (ie, from year 2 to year 4: β = 1.67, P = .019).

Conclusions: Despite actively receiving treatment for BD, participants with a history of interpersonal trauma—particularly childhood trauma—presented with more severe depressive symptoms at several follow-up assessments. Hence, interpersonal trauma may represent an essential treatment target.

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