Adverse childhood experiences, including child maltreatment (CM), are relevant environmental risk factors for bipolar disorder (BD). However, little is known about the interaction of the type, duration and frequency of abuse with the timing of abuse in BD. The aim of this study was to investigate the different patterns of childhood trauma (frequency, type and chronology) between BD patients and healthy controls (HCs) and to identify BD-sensitive periods of exposure to CM that could influence functioning outcomes. The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the importance of the type and timing of maltreatment in a sample of 60 patients diagnosed with euthymic BD. Additionally, 76 HCs were recruited for comparison. All participants were of European-Caucasian origin and were assessed in the 2016-2019 period. To identify the variables that maximally differentiated the type and timing of exposure to CM between the BD and HC groups, a linear mixed effects model and random forest (RF) analyses were applied. We showed that multiplicity and severity, nonverbal emotional abuse, witnessing interparental violence and emotional neglect were the main factors associated with BD. In addition, regarding the occurrence of maltreatment in BD patients, we identified two sensitive periods with a principal peak at the age of 6 and a secondary peak at the age of 11. Functionality at the assessment time was associated with CM in adolescence for both HC and BD participants. Although the sample size and retrospective nature of the MACE instrument were the main limitations of our study, we were unable to explore the role of variables such as sex or socioeconomic status. We concluded that the multiplicity and sensitivity of CM exposure, mainly of the emotional type, during middle childhood are important risk factors for BD, at least in the European-Caucasian cultural setting.

不良童年经历，包括虐待儿童 (CM)，是双相情感障碍 (BD) 的相关环境风险因素。然而，关于滥用类型、持续时间和频率与 BD 滥用时间之间的相互作用知之甚少。本研究的目的是调查 BD 患者和健康对照 (HC) 之间的不同童年创伤模式（频率、类型和时间顺序），并确定可能影响功能结果的 CM 暴露的 BD 敏感期。虐待和虐待年表暴露 (MACE) 量表用于评估 60 名诊断为正常 BD 患者样本中虐待类型和时间的重要性。此外，还招募了 76 名 HC 进行比较。所有参与者都是欧洲高加索人，并在 2016-2019 年期间接受了评估。为了确定最大程度区分 BD 和 HC 组之间暴露于 CM 的类型和时间的变量，应用了线性混合效应模型和随机森林 (RF) 分析。我们发现，多重性和严重性、非语言情感虐待、目睹父母间的暴力和情感忽视是与 BD 相关的主要因素。此外，关于 BD 患者虐待的发生，我们确定了两个敏感期，主要高峰在 6 岁，次要高峰在 11 岁。评估时的功能与两种 HC 的青春期 CM 相关和 BD 参与者。尽管 MACE 工具的样本量和回顾性是我们研究的主要局限，但我们无法探索性别或社会经济地位等变量的作用。