The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
Effects of trauma on bipolar disorder: the mediational role of interpersonal difficulties and alcohol dependence
Version of Record online: 6 FEB 2008
© 2008 Blackwell Munksgaard
Volume 10, Issue 2, pages 293–302, March 2008
How to Cite
Maguire, C., McCusker, C. G., Meenagh, C., Mulholland, C. and Shannon, C. (2008), Effects of trauma on bipolar disorder: the mediational role of interpersonal difficulties and alcohol dependence. Bipolar Disorders, 10: 293–302. doi: 10.1111/j.1399-5618.2007.00504.x
- Issue online: 6 FEB 2008
- Version of Record online: 6 FEB 2008
- Received 30 May 2006, revised and accepted for publication 31 January 2007
- alcohol dependence;
- bipolar disorder;
- depressive symptoms;
- interpersonal difficulties;
- posttraumatic stress disorder (PTSD);
- quality of life;
Objectives: This study examined: (i) the prevalence of trauma in a bipolar disorder (BD) sample, and (ii) how trauma histories mediated by interpersonal difficulties and alcohol dependence impact on the severity of BD. The prevalence of posttraumatic stress disorder (PTSD) and its relationship to outcomes in BD were also examined.
Methods: Sixty participants were recruited from a geographically well-defined mental health service in Northern Ireland. Self-reported trauma histories, PTSD, interpersonal difficulties and alcohol dependence and were examined in relation to illness severity.
Results: A high prevalence of trauma was found. Trauma predicted the frequency of hospital admissions (R2 = 0.08), quality of life (R2 = 0.23) and inter-episode depressive symptoms (R2 = 0.13). Interpersonal difficulties, but not alcohol dependence, appeared to play an important role in mediating these adverse effects. While only 8% of the sample met criteria for active PTSD, this comorbid disorder was associated with BD severity.
Conclusions: This study indicates that awareness of trauma is important in understanding individual differences in bipolar presentations. The theoretical and clinical implications of evidence that trauma is related to more adverse outcomes in BD are discussed. The finding that interpersonal difficulties mediate the relationship between trauma and BD severity is novel. The need for adjunctive evidence-based treatments targeting interpersonal difficulties is considered.