Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

Jack Cotter, Michael Kaess, Alison Yung

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objectives.
    We aimed to examine the association between childhood trauma and functional impairment in psychotic
    disorders, bipolar disorder and borderline personality disorder, to speculate on possible mechanisms that underlie this
    association and discuss the implications for clinical work.
    Methods.
    Narrative review of the peer-reviewed English language literature in the area.
    Results.
    High rates of childhood trauma in psychotic disorders, bipolar disorder and borderline personality disorder
    were identi
    fi
    ed. This was associated with impaired social and occupational functioning in both the premorbid and
    established phases of each of these psychiatric disorders over and above the de
    fi
    cits typically observed in these popula-
    tions. Possible mechanisms mediating this relationship include neurocognitive de
    fi
    cits, insecure attachment, higher rates
    of comorbidities and problems with adherence and response to treatment.
    Conclusions.
    Routine clinical inquiry about childhood maltreatment should be adopted within mental health settings.
    This has potentially important treatment implications for identifying those individuals at elevated risk of functional
    disability. While there is no clear guidance currently available on how to target childhood trauma in the treatment of
    psychotic disorders, bipolar disorder or borderline personality disorder, there are several promising lines of enquiry and
    further research is warranted.
    Original languageEnglish
    Pages (from-to)21-30
    JournalIrish Journal of Psychological Medicine (Online)
    Volume32
    Issue number1
    Early online date10 Dec 2014
    DOIs
    Publication statusPublished - Mar 2015

    Keywords

    • Bipolar disorder
    • Borderline personality disorder
    • Child abuse
    • Childhood trauma
    • Functioning
    • Psychosis
    • Schizophrenia

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