L’impact de l’état de stress post-traumatique comorbide sur les patients atteints de troubles bipolaires

L’impact de l’état de stress post-traumatique comorbide sur les patients atteints de troubles bipolaires

Un article sur L’impact de l’état de stress post-traumatique comorbide sur les patients atteints de troubles bipolaires a été publié dans le Journal of Affective Disorders.

A retenir : L’ESPT augmente les tentatives de suicide, les cycles rapides et les symptômes maniaques

Background

Available data regarding posttraumatic stress disorder (PTSD) in bipolar disorder (BD) are scarce and usually from a limited sample size. The present report was carried out using the Brazilian Research Consortium for Bipolar Disorders and aimed to examine whether patients with BD and comorbid PTSD are at an increased risk for worse clinical outcomes.

Methods

A consecutive sample of bipolar I outpatients from two teaching hospitals in Brazil was recruited. Patients were assessed using the Structured Clinical Interview for DSM-IV, Young Mania Rating Scale, 17-item Hamilton Rating Scale for Depression, and quality of life instrument WHOQOL-BREF. Participants were divided into three groups: a. bipolar patients with PTSD, b. bipolar patients exposed to trauma without PTSD, and c. bipolar patients with no trauma exposure.

Results

Of the 405 patients who consented to participate, 87.7% completed the survey. All three groups were similar in terms of demographic parameters. The group with comorbid PTSD reported worse quality of life, more rapid cycling, higher rates of suicide attempts, and a lower likelihood of staying recovered.

Limitations

The cross-sectional design excludes the opportunity to examine causal relationships among trauma, PTSD, and BD.

Conclusions

The findings indicate that PTSD causes bipolar patients to have a worse outcome, as assessed by their lower likelihood to recover, elevated proportion of rapid cycling periods, increased risk of suicide attempts, and worse quality of life.

Les auteurs : Lucas C. Quarantini, Ângela Miranda-Scippa, Fabiana Nery-Fernandes, Monica Andrade-Nascimento, Amanda Galvao-de Almeida, José L. Guimaraes, Carlos A.S. Teles, Liana R. Netto, Sidnei B. Lira, Irismar R. de Oliveira, Robert M. Post, Flavio Kapczinski, Karestan C. Koenen

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