Bipolar disorder (BD) patients are twice as likely to suffer from post-traumatic stress disorder (PTSD) in the face of a traumatic event as the general population, suggest study results.

Study results also showed that PTSD in BD patients was associated with worse clinical outcome and increased illness severity, suggesting that “more attention should be drawn to comorbid PTSD in clinical care of BD patients,” according to Hans-Jorg Assion (Ruhr-University Bochum, Germany) and colleagues.

Using the Post-Traumatic Stress Diagnostic Scale (PDS) and the Clinician Administered PTSD Scale, the researchers assessed 74 BD I patients aged 48.3 years on average.

Overall, 50.0% of BD patients self-reported no trauma (BD??”), 29.7% had experienced traumatic events without a diagnosis of PTSD (BD+), and 20.3% had a definite diagnosis of PTSD (BD+P) according to the PDS. The 20.3% lifetime PTSD prevalence rate observed in this study is twice as high as that seen in the general population, say the researchers.

The researchers also found that the rate of lifetime exposure to at least one traumatic event was 50% in the cohort, which is similar to that seen in the general population.

“The discrepancy between the comparable expected rate of trauma exposure and higher prevalence rate of PTSD in patients with BD indicates a specific vulnerability of BD patients to trauma exposure,” writes the team in the journal Social Psychiatry and Psychiatric Epidemiology.

Furthermore, compared with BD??” and BD+ patients, BD+P patients had significantly higher scores on the Hamilton Depression Rating Scale (16.6 vs 7.7 and 9.6) and significantly lower scores on the Clinical Global Functioning scale (60 vs 72 and 68).

“These findings provide support for the argument that lifetime diagnosis of PTSD, but not reported trauma itself, worsens the clinical course of BD,” say the authors.

Patients with PTSD were also significantly more likely to have at least one alcoholic parent and to have suffered more severe physical violence by parents, parental disregard, and sexual assault by a family member or acquaintance compared with patients without PTSD.

Based on their findings, the researchers call for further studies focusing on protective psychosocial steps and psychotherapeutic strategies in the treatment of traumatic experiences and PTSD in BD.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

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