1. A consistent finding was that depressed mood is a central symptom and/or core feature of depression in bipolar disorder, regardless of participants' history of childhood trauma.
2. Feelings of worthlessness emerged as an additional symptom for individuals with a history of childhood trauma.

Significant outcomes

Individuals with BD who have a history of childhood trauma report more depressive episodes and experience more severe depressive symptoms, than individuals with-out a history of childhood trauma.

Specific results

The network among participants without a history of child-hood trauma comprised 29 edges/connections. The strongest edge was between depressed mood (2) and suicidal ideation (9). The symptoms with the greatest connections to each other were depressed mood (2), loss of  interest (1), and insomnia/hypersomnia (3). The symptoms with the greatest expected influence were depressed mood (2), fatigue/loss of energy (4), and loss of interest (1).

No childhood trauma

The network among participants with a history of any childhood trauma consisted of 34 edges/connections. The strongest was between loss of interest (1) and depressed mood (2). Depressed mood (2), feelings of  worthlessness (6), and insomnia/hypersomnia (3) had the greatest connections. Depressed mood (2), loss of interest (1), and feelings of   worthlessness (6) had the greatest expected influence.

Any childhood trauma

Networks of depressive symptoms (self-reported)

Networks of depressive symptoms (clinician-rated)

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.

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

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.

Methods

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.

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