Introduction: Environmental and genetic factors, relationships and experiences
established in the early years of life are involved in the etiology of bipolar affective
disorder (BAD). The aim was to determine the frequency of childhood traumas,
attachment styles, alexithymia and dissociative symptoms in BAD patients, to
compare them with the healthy population, and to examine the direct and indirect
relationships of childhood traumas with BAD.
Methods: The study included 100 patients diagnosed with BAD according to
DSM-IV TR diagnostic criteria and who had been euthymic for the last 2 months,
and 100 healthy individuals matched for age and gender. The participants were
administered the Sociodemographic Data Form, Childhood Trauma Questionnaire,
Dissociative Experiences Scale, Toronto Alexithymia Scale, Experiences in Close
Relationships Inventory-II, Hamilton Depression Scale and Young Mania Scale.
Results: In the BAD group, childhood traumas, insecure attachment types,
dissociative symptoms and alexithymia were found to be significantly higher than
in healthy individuals. A positive relationship was found between physical abuse,
dissociation and alexithymia levels and the number of attacks. Being physically
abused was associated with earlier onset of the disease. A positive relationship
was found between emotional abuse, physical neglect and total trauma score and
dissociation. Trauma types other than sexual abuse were found to be associated
with difficulty in recognizing and expressing emotions. It has been found that there
is a relationship between emotional abuse and avoidant attachment dimensions.
Alexithymia levels were found to be high in patients with early-onset BAD. It has
been found that having a family history of psychopathology increases the risk
of developing BAD, while externally oriented thinking and marital status protect
against the disease.
Conclusions: There is a relationship between childhood traumas, attachment
types, dissociative and alexithymic characteristics in BAD. Our study reveals that
emotional and physical abuse in childhood affects the development of BAD
and the course of the disease, and the importance of holistic evaluation of the
individual in terms of clinical course and treatment process.
Keywords: Alexithymia, attachment, bipolar disorder, childhood trauma,
dissociation