Trauma and comorbid post-traumatic stress disorder in people with bipolar disorder participating in the Heinz C. Prechter Longitudinal Study

Samantha E Russell; Anna L Wrobel; Mojtaba Lotfaliany; Melanie M Ashton; Ravleen Kaur; Anastasia K Yocum; Elizabeth R Duval; Claudia Diaz-Byrd; Tobin J Ehrlich; David F Marshall; Michael Berk; Melvin G McInnis; Olivia Dean; Alyna Turner

doi:10.1016/j.jad.2023.12.058

Trauma and comorbid post-traumatic stress disorder in people with bipolar disorder participating in the Heinz C. Prechter Longitudinal Study

J Affect Disord. 2024 Mar 1:348:275-282. doi: 10.1016/j.jad.2023.12.058. Epub 2023 Dec 30.

Affiliations

¹ Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, PO Box 281, Geelong 3220, Australia.
² Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, PO Box 281, Geelong 3220, Australia; Orygen, Parkville, Victoria, Australia.
³ Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.
⁴ Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁵ Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, PO Box 281, Geelong 3220, Australia; Orygen, Parkville, Victoria, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville 3052, Australia; University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
⁶ Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, PO Box 281, Geelong 3220, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville 3052, Australia.
⁷ Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, PO Box 281, Geelong 3220, Australia; School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan 2308, Australia. Electronic address: a.turner@deakin.edu.au.

PMID: 38163569
DOI: 10.1016/j.jad.2023.12.058

Abstract

Background: It is estimated that up to 50 % of people with bipolar disorder (BD) also have comorbid post-traumatic stress disorder (PTSD). However, little is known about the presentation and treatment of people with this comorbidity.

Methods: Data from 577 individuals diagnosed with bipolar disorder participating in the Heinz C. Prechter Longitudinal Study of BD were explored at baseline, year two and four. Three trauma groups were created: (i) one trauma (n = 75), (ii) multiple traumas (n = 417), and comorbid PTSD (n = 85). Measures of depression, mania, sleep, number of hospitalisations, suicide attempts, and medication use were analysed using regression modelling to determine differences between the three trauma groups.

Results: There was an increase in depression, mania, and sleep scores and a higher number of hospitalisations in participants with comorbid PTSD compared to those experiencing one trauma. Additionally, increased mania and depression scores were reported in participants experiencing multiple traumas compared to those with one trauma. There was no difference in medication use between those who experienced one trauma compared to those with comorbid PTSD.

Limitations: The trauma groups may include confounding with more participants experiencing PTSD than reported in this study due to screening processes. Additionally, the severity of trauma was not recorded, therefore number of traumas was utilised as a proxy.

Conclusion: Comorbid BD and PTSD is associated with worse symptom scores compared to participants reporting one trauma. Clinical implications include the addition of trauma-informed care to clinical settings to identify PTSD to provide appropriate treatments.

Keywords: Bipolar disorder; Comorbidity; Depression; Mania; Post-traumatic stress disorder; Psychiatry; Stress; Trauma.

MeSH terms

Bipolar Disorder* / diagnosis
Bipolar Disorder* / epidemiology
Comorbidity
Humans
Longitudinal Studies
Mania
Multiple Trauma*
Stress Disorders, Post-Traumatic* / diagnosis