Childhood trauma, primary emotional systems, and suicidal ideation in youths with bipolar disorders

Background: Bipolar disorders (BD) in youths are strongly associated with lifetime suicidal ideation. Nevertheless, primary emotional systems (PES) contributing to this association are poorly understood. Besides this, childhood trauma is a prominent environmental stressor associated with both BD diagnosis and suicide. The aim of this study was to investigate the distribution patterns of PES and childhood trauma in youths’ BD with and without suicidal ideation (BD-IS, BD-NIS). Methods: We assessed 289 participants, 103 youths with DSM-5 BD and 186 healthy controls (HCs). PES were obtained with the Affective Neuroscience Personality Scales (ANPS) and history of childhood trauma using the Childhood Trauma Questionnaire (CTQ). Suicidal ideation was assessed through the Columbia Suicide Scale for the Rating of Suicide Severity (C-SSRS). The associations with suicidal ideation were tested using two different multivariate models. Results: Over 48% of participants reported lifetime suicidal ideation. According to the first model (p<0.0001), BD-IS scored higher on the ANPS-ANGER and lower on ANPS-PLAY and ANPS-CARE than both HCs and BD-NIS, while BD-NIS reported higher and lower scores than HC. BD-IS and BD-NIS reported higher scores on ANPS-SEEK than HCs. BD-IS reported more emotional abuse, sexual abuse, physical abuse and emotional neglect than HCs, but only more emotional abuse than BD-NIS. ANPS-ANGER (OR: 1.13) and CTQ-Emotional abuse (OR:1.26) were independent predictors of suicidal ideation in youths with BD. Conclusions: Findings support the importance of assessing primary emotional systems and childhood trauma, in particular emotional abuse, in youths with BD at risk for suicide.