It is worth noting that feelings of worthlessness emerged as an additional symptom in the network of self-reported depressive symptoms among participants with—but not without—a history of any childhood trauma. The experience of shame—which  can  manifest  as  a  sense  of  inadequacy  or worthlessness—can have a debilitating consequence of childhood trauma. If this study/results are replicated, it would imply that patients with BD who report a history of childhood trauma may especially benefit from psychological treatments that target feelings of worthlessness.

Feelings of worthlessness

Addressing central symptoms—such as depressed mood—may  represent an effective target/strategy for treating depressive symptoms among patients with BD encountered in clinical practice.

Additionally, identifying and addressing feelings of worthlessness during the treatment of depressive symptoms may be especially helpful for patients with BD who report a history of childhood trauma. For example, psychological interventions that help patients to recognize, acknowledge, and alter their negative or unhelpful thought patterns—such as CBT (cognitive behavioral therapy) —may be suitable.

Future implications

This study characterized and compared the networks of both self-reported  and  clinician-rated depressive symptoms among participants with BD with and without a history of childhood trauma. The most consistent finding was that depressed mood emerged as a central symptom (9 out of 32 networks) in patients with BD.  This is regardless of participants' history or no history of childhood trauma. This reinforces the fact that depressed mood is a core feature of depression in BD.

Pepperdine University

Summary of article:

Wrobel, AL, Cotton, SM, Jayasinghe, A, et al. Childhood trauma and depressive symptoms in bipolar disorder: A network analysis. Acta Psychiatr Scand. 2023; 147(3): 286-300. doi:10.1111/acps.13528

Childhood trauma and depressive symptoms in bipolardisorder: A network analysis

Depressed mood consistently emerged as a central symptom; regardless of participants' history of childhood trauma. Additionally, feelings of worthlessness emerged as a key symptom in the network of self-reported depressive symptoms among participants with—but not without—a history of childhood trauma.

Summary of results

Data from 543 participants were used.  67.2% were women with a mean age of 50.3. This data was used to estimate the networks of self-reported and clinician-rated depressive symptoms. Self-reported (Patient Health Questionnaire) and clinician-rated (Hamilton Depression Rating Scale) scales were used for individual depressive symptoms. These were used among participants with bipolar disorder with and without a history of childhood trauma (Childhood Trauma Questionnaire), which were characterized and compared.

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