Objectives: 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.
Methods 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:
Mood Symptoms: BD\u3eMD in BPRS total score (p=0.06), BPRS Mania subscale (p=0.05),YMRS total score (p=0.06) BD\u3eMD in total number of mood episodes identified with KID-SCID: •MDE (p=0.04) Mania (without high outlying value) (p = 0.07)
Substance use: No difference as assessed using CRAFT
PTSD and trauma recollection: No differences in PTSD symptoms as assessed by PCL-C BD\u3eMD abuse identified with CTQ. Sexual abuse (without high outlying value) (p = 0.05). Physical neglect (p=0.07)
Medications: BD\u3eMD 1.33 fewer medications (t=11.9, p=0.17)
Conclusions 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
