Prevalence and correlates of physical and sexual abuse in children and adolescents with bipolar disorder

Objective: Adult bipolar disorder (BP) has been associated with lifetime history of physical and sexual abuse. However, there are no reports of the prevalence of abuse in BP youth. The objective of this study was to examine the prevalence and correlates of physical and/or sexual abuse among youth with BP spectrum disorders. Methods: Four hundred forty-six youths, ages 7 to 17 years (12.7 ± 3.2), meeting DSM-IV criteria for BP-I (n = 260), BP-II (n = 32) or operationalized definition of BP-NOS (n = 154) were assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime version (K-SADS-PL). Abuse was ascertained using the K-SADS. Results: Twenty percent of the sample experienced physical and/or sexual abuse. The most robust correlates of any abuse history were living with a non-intact family (OR = 2.6), lifetime history of posttraumatic stress disorder (PTSD) (OR = 8.8), psychosis (OR = 2.1), conduct disorder (CD) (OR = 2.3), and first-degree family history of mood disorder (OR = 2.2). After adjusting for confounding demographic factors, physical abuse was associated with longer duration of BP illness, non-intact family, PTSD, psychosis, and first-degree family history of mood disorder. Sexual abuse was associated with PTSD. Subjects with both types of abuse were older, with longer illness duration, non-intact family, and greater prevalence of PTSD and CD as compared with the non-abused group. Limitations: Retrospective data. Also, since this is a cross-sectional study, no inferences regarding causality can be made. Conclusion: Sexual and/or physical abuse is common in youth with BP particularly in subjects with comorbid PTSD, psychosis, or CD. Prompt identification and treatment of these youth is warranted.