19th Latest Advances in Psychiatry International Symposium

Abstract

There is evidence that maltreatment in childhood increases the risk of developing psychiatric disorders in adulthood. The most common disorders associated with physical abuse are attention-deficit hyperactivity disorder, suicide attempts, post-traumatic stress disorder and bipolar disorder.1 Childhood maltreatment also increases the risk of poor physical health in adulthood,2 and maltreatment influences brain structure, function and connectivity.3 There is a significant association between emotional abuse and bipolar disorder (BD).4 In a meta-analysis of 19 studies the odds ratio for emotional abuse compared with those who had not experienced abuse was 4.04 (95% CI, 3.12–5.22; p<0.001).5 Childhood maltreatment is associated with an increase in the severity and complexity of bipolar disorder, psychiatric comorbidity and duration of untreated illness, and a decrease in the response to lithium.6–9 Also the greater the number of types of abuse experienced the earlier the age of onset of BD.6 Bipolar disorder is known to have a significant genetic component, with heritability of about 60–65%. Environmental determinants also play a role in the vulnerability to BD.10 In combination with early life stressors genetic factors may create a priming effect leading to subtle pre-clinical symptoms so that susceptible individuals of this type when exposed to later life stressors such as cannabis may go on to develop psychopathology.11,12