Childhood Trauma Exposure Associated With a More Severe Course of Metabolic Disturbances in Bipolar Disorder: A 36-Month Longitudinal Prospective Cohort Study.
7 affiliations
- 1Clínica De Nuestra Señora De La Paz, Orden Hospitalaria de San Juan De Dios, Center for Clinical and Translational Research, Bogotá D.C., Colombia.
- 2Center For Clinical and Translational Research, Universidad Simón Bolívar, Barranquilla, Colombia.
- 3Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
- 4School of Medicine, Universidad De Los Andes, Bogotá D.C., Colombia.
- 5Department of Dermatology, Stanford University, Palo Alto, California, USA.
- 6Healthy Longevity Center, Universidad de la Costa, Barranquilla, Colombia.
- 7Department of Psychiatry, University of Toronto, Toronto, Canada.
Abstract
Background
Childhood trauma (CT) is a recognized risk factor for adverse psychiatric and physical health outcomes in individuals with bipolar disorder (BD). However, few prospective studies have examined how CT relates to the longitudinal course of metabolic dysregulation in BD. This study aimed to describe the association between CT exposure and the progression of metabolic disturbances over 36 months in adults with BD.Methods
In this prospective cohort study, 305 adults diagnosed with BD (Types I and II) were followed across 13 visits over 36 months. Participants were stratified according to CT exposure using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Metabolic outcomes (HbA1c, BMI, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and hs-CRP) were analyzed with inverse probability of treatment weighting (IPTW) and linear mixed-effects models incorporating a group-by-time interaction.Results
Of the 305 participants enrolled, 53 (17.4%) were lost to follow-up. Longitudinal analyses showed significant CT-by-time interactions for all metabolic markers (p < 0.001). At 36 months, participants exposed to CT showed greater increases than non-exposed participants in HbA1c (adjusted least-squares mean difference 1.11%, 95% CI 0.89-1.33), BMI (4.46 kg/m², 95% CI 3.90-5.03), and hs-CRP (2.68 mg/L, 95% CI 2.52-2.84), together with unfavorable changes in the lipid profile. Effect sizes were large (Cohen's d > 0.8). These associations persisted after IPTW weighting for measured baseline covariates.Conclusions
In this observational cohort, CT exposure was associated with an accelerated trajectory of metabolic deterioration in individuals with BD after weighting for measured baseline characteristics. Because the design is observational and several behavioral, socioeconomic, and illness-course determinants of metabolic risk were not measured, these findings should be interpreted as associations rather than as causal effects. They nonetheless support the value of early trauma-informed assessment and of integrated care strategies addressing both psychiatric and physical health in BD. Future research should incorporate detailed lifestyle and treatment-exposure data, additional inflammatory biomarkers, and preventive interventions to mitigate long-term cardiometabolic risk in this vulnerable population.
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BibTeX
@article{galvezflorez2026childhood,
title = {{Childhood Trauma Exposure Associated With a More Severe Course of Metabolic Disturbances in Bipolar Disorder: A 36-Month Longitudinal Prospective Cohort Study.}},
author = {Juan F Galvez-Florez and Hernán F Guillen-Burgos and Sergio Moreno-López and Mariana Ramírez-Posada and Juan-Manuel Anaya and Roger S McIntyre},
journal = {Brain and behavior},
year = {2026},
month = oct,
doi = {10.1002/brb3.71789},
url = {https://europepmc.org/article/MED/42926321},
note = {CC BY},
}
RIS
TY - JOUR
TI - Childhood Trauma Exposure Associated With a More Severe Course of Metabolic Disturbances in Bipolar Disorder: A 36-Month Longitudinal Prospective Cohort Study.
AU - Juan F Galvez-Florez
AU - Hernán F Guillen-Burgos
AU - Sergio Moreno-López
AU - Mariana Ramírez-Posada
AU - Juan-Manuel Anaya
AU - Roger S McIntyre
PY - 2026
DA - 2026/10/01
JO - Brain and behavior
DO - 10.1002/brb3.71789
UR - https://europepmc.org/article/MED/42926321
AB - Background Childhood trauma (CT) is a recognized risk factor for adverse psychiatric and physical health outcomes in individuals with bipolar disorder (BD). However, few prospective studies have examined how CT relates to the longitudinal course of metabolic dysregulation in BD. This study aimed to describe the association between CT exposure and the progression of metabolic disturbances over 36 months in adults with BD.Methods In this prospective cohort study, 305 adults diagnosed with BD (Types I and II) were followed across 13 visits over 36 months. Participants were stratified according to CT exposure using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Metabolic outcomes (HbA1c, BMI, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and hs-CRP) were analyzed with inverse probability of treatment weighting (IPTW) and linear mixed-effects models incorporating a group-by-time interaction.Results Of the 305 participants enrolled, 53 (17.4%) were lost to follow-up. Longitudinal analyses showed significant CT-by-time interactions for all metabolic markers (p < 0.001). At 36 months, participants exposed to CT showed greater increases than non-exposed participants in HbA1c (adjusted least-squares mean difference 1.11%, 95% CI 0.89-1.33), BMI (4.46 kg/m², 95% CI 3.90-5.03), and hs-CRP (2.68 mg/L, 95% CI 2.52-2.84), together with unfavorable changes in the lipid profile. Effect sizes were large (Cohen's d > 0.8). These associations persisted after IPTW weighting for measured baseline covariates.Conclusions In this observational cohort, CT exposure was associated with an accelerated trajectory of metabolic deterioration in individuals with BD after weighting for measured baseline characteristics. Because the design is observational and several behavioral, socioeconomic, and illness-course determinants of metabolic risk were not measured, these findings should be interpreted as associations rather than as causal effects. They nonetheless support the value of early trauma-informed assessment and of integrated care strategies addressing both psychiatric and physical health in BD. Future research should incorporate detailed lifestyle and treatment-exposure data, additional inflammatory biomarkers, and preventive interventions to mitigate long-term cardiometabolic risk in this vulnerable population.
SN - 2162-3279
ER -