Objective: Patients with bipolar disorders have a high risk of suicidal behavior. Childhood maltreatment is a well-established risk factor for suicidal behavior. The objective of this study was to examine the association between childhood-maltreatment subtypes and vulnerability to suicide attempts in bipolar disorder using the Childhood Trauma Questionnaire (CTQ). Methods: A literature review was performed using the MEDLINE, Embase, and PsycINFO databases. Thirteen studies met the selection criteria. In the meta-analysis, the Childhood Trauma Questionnaire (CTQ) was used to assess a wide range of childhood maltreatment subtypes, which were analyzed by using a random-effects model to account for the likely variations of true effect sizes between the included studies. Results: In the systematic review, 13 studies met the selection criteria. The CTQ was selected for the meta-analysis to increase the homogeneity of assessment and to encompass a wide range of childhood-maltreatment subtypes. The data were analyzed using a random-effects model. Compared to bipolar non-attempters, bipolar suicide attempters had experienced childhood maltreatment with a significantly higher frequency and had higher total CTQ scores (Hedges’ g = -0.38, 95%CI -0.52 to -0.24, z = -5.27, p < 0.001) and CTQ sub-scores (sexual abuse: g = -0.39, 95%CI -0.52 to -0.26, z = -5.97; physical abuse: g = -0.26, 95%CI -0.39 to -0.13, z = -4.00; emotional abuse: g = -0.39, 95%CI -0.65 to -0.13, z = -2.97; physical neglect: g = -0.18, 95%CI -0.31 to -0.05, z = -2.79; emotional neglect: g = -0.27, 95%CI -0.43 to -0.11, z = -3.32). Conclusions: Childhood maltreatment, as assessed by the CTQ, may contribute to an increased risk of suicidal behavior among people with bipolar disorders. Recognizing maltreatment as an etiological risk factor is a crucial step toward furthering science-based preventive psychiatry.

中文翻译：

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有自杀行为的双相障碍患者的童年虐待亚型：系统评价和荟萃分析

目的：双相情感障碍患者有很高的自杀行为风险。童年虐待是自杀行为的一个公认的危险因素。本研究的目的是使用童年创伤问卷 (CTQ) 检查童年虐待亚型与双相情感障碍自杀企图的易感性之间的关联。方法：使用 MEDLINE、Embase 和 PsycINFO 数据库进行文献综述。13 项研究符合选择标准。在荟萃分析中，儿童创伤问卷 (CTQ) 用于评估广泛的儿童虐待亚型，并通过使用随机效应模型进行分析，以解释纳入研究之间真实效应大小的可能变化。结果：在系统评价中，13 项研究符合选择标准。CTQ 被选择用于荟萃分析，以增加评估的同质性并涵盖广泛的儿童虐待亚型。使用随机效应模型分析数据。与双相非尝试者相比，双相自杀未遂者经历儿童期虐待的频率明显更高，总 CTQ 得分更高（Hedges' g = -0.38, 95% CI -0.52 to -0.24, z = -5.27, p < 0.001 ) 和 CTQ 子分数（性虐待：g = -0.39，95%CI -0.52 至 -0.26，z = -5.97；身体虐待：g = -0.26，95%CI -0.39 至 -0.13，z = -4.00 ；情感虐待：g = -0.39，95%CI -0.65 至 -0.13，z = -2.97；身体忽视：g = -0.18，95%CI -0.31 至 -0.05，z = -2.79；情感忽视：g = -0.27, 95% CI -0.43 到 -0.11, z = -3.32)。结论：由 CTQ 评估的儿童期虐待，可能会增加双相情感障碍患者的自杀行为风险。认识到虐待是一种病因风险因素，是推进以科学为基础的预防精神病学的关键一步。