Department of Psychiatry
Bipolar Disorder; Children; Mood Disorders; Stress Disorders, Traumatic
- To characterize the relationship between childhood trauma/abuse, and mood dysregulation, and between childhood trauma/abuse and pediatric bipolar disorder (BD).
- To describe the clinical correlates and demographics of children with trauma/abuse and comorbid mood disorders in a community mental health setting.
- To explore associations between the diagnosis of BD in youth with histories of trauma and a family history of BD, the presence of specific symptom clusters, the presence of pretrauma mood symptoms.
- We are assessing youths ages 8-18 who present with mood symptoms and past trauma divided into two groups: (1) Trauma Mood Disorder NOS (T+MD); (2) Trauma+Unmodified DSM-IV-TR BD (T+BD).
- Differences in clinical variables between groups are analyzed using t-tests for continuous and chi-square tests for categorical variables (α= 0.05).
- Youth are evaluated using the following psychiatric rating scales: (1) Structured Clinical Interview for DSM Disorders, Childhood Disorders Form (KID-SCID) mood module to establish the diagnosis of BD; (2) Brief Psychiatric Rating Scale for Children (BPRS-C); (3)Young Mania Rating Scale (YMRS); (4)Children’s Depression Rating Scale-Revised (CDRS-R); (5) Childhood Trauma Questionnaire (CTQ); (6) PTSD CheckList –Civilian Version (PCL-C); (7)Attention Deficit Hyperactivity Disorder IV (ADHD-IV) Rating Scale; (8) Substance Abuse (SA) screen: CRAFFT
- Other information obtained includes: Demographic characteristics and socioeconomic status; Number of medications and types; Percent of with a lifelong history of psychiatric hospitalization/out of home placement; Family history of psychiatric illness and substance use disorders
Results - Clinical presentations:
- BD>MD in BPRS total score (p=0.06), BPRS Mania subscale (p=0.05),YMRS total score (p=0.06)
- BD>MD in total number of mood episodes identified with KID-SCID: •MDE (p=0.04)
- Mania (without high outlying value) (p = 0.07)
- No difference as assessed using CRAFT
PTSD and trauma recollection:
- No differences in PTSD symptoms as assessed by PCL-C
- BD>MD abuse identified with CTQ. Sexual abuse (without high outlying value) (p = 0.05). Physical neglect (p=0.07)
- BD>MD 1.33 fewer medications (t=11.9, p=0.17)
- Further data collection is ongoing to achieve our targeted sample size in order to identify clinical correlates in mood dsyregulated, traumatized youth.
- This will promote future research aimed at identifying biomarkers and preventive interventions.
2011 American Academy of Child & Adolescent Psychiatry Annual Meeting
Dvir Y, Hill M, Frazier JA. (2011). Mood Disorders and Trauma – What are the Associations?. Psychiatry Publications. Retrieved from https://escholarship.umassmed.edu/psych_pp/498