A new study, published in the British Journal of Psychiatry, found that experiences of neglect, abuse, and bullying in childhood were linked with later diagnoses of Bipolar Disorder. The researchers, led by Dr. Palmier-Claus at the University of Manchester, statistically analyzed data from 19 studies, allowing them to combine the results of 34 years of patient records. They found that people diagnosed with Bipolar Disorder were 2.63 times more likely to have experienced traumatic events in childhood than people without the diagnosis. This suggests that whether or not there is a genetic component to the disorder, the impact of experiences such as neglect and physical and sexual abuse cannot be ignored.
Last month, the National Institute of Mental Health (NIMH) announced that it is funding a $15.4 million effort led by the pharmaceutical industry to attempt to identify the neurobiological basis for Schizophrenia and Bipolar Disorder. Leaders from Janssen Biotech, the makers of haloperidol, citalopram, and risperidone, are partnering with researchers from Johns Hopkins and the Salk Institute to attempt to find theorized biological markers that could be targeted with medication.
The group acknowledges that our current medical treatments for these disorders have limited efficacy and that previous efforts to locate biological markers have been unsuccessful, yet they insist that further study will eventually locate elusive biomarkers underlying specific mental illnesses.
In fact, the very existence of categorizable mental illness diagnoses has been questioned. In 2013, prior to the release of the DSM-5, the director of the NIMH, Thomas Insel, stated that the weakness of the DSM “is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”
Insel’s response to this lack of validity was to increase the funding for neurobiological research in a desperate attempt to find categories of mental illness with obvious biomarkers that could be targeted with medication.
However, the current study, which demonstrates the impact of past experiences on the formation of mental illness, adds to a growing body of literature that indicates that this search may be fruitless. The researchers conducted a statistical synthesis, examining 19 prior studies that included participants diagnosed with bipolar disorder, a measure of childhood adversity, and a comparison sample. Those diagnosed with the disorder were found to be 2.63 times more likely to report having experienced childhood adversity than the control group. The results also suggest that those who experienced emotional abuse were at an even higher risk and were about four times as likely to be diagnosed with bipolar disorder.
Perhaps efforts should focus on preventing childhood trauma, as that has been linked far more often to mental illness than neurobiology. Perhaps instead of devoting more and more resources to an uncertain search for biomarkers, resources should be devoted to providing support for those who are experiencing poverty, abuse, and trauma.
Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. British Journal of Psychiatry,209(4), bjp.bp.115.179655, doi: 10.1192/bjp.bp.115.179655 (Abstract)