Childhood trauma, loneliness, and quality of life in adults with euthymic bipolar disorder

Background: Individuals with childhood trauma may experience loneliness throughout their lives, which can potentially aggravate mental and physical health conditions. Moreover, accumulating evidence suggests that associations exist between childhood trauma and certain features of bipolar disorder (BD), including cognitive dysfunction, severity, and clinical course. But, it remains unclear whether loneliness is associated with childhood trauma or quality of life in adult patients with BD. Methods: We recruited 83 patients with euthymic BD and 40 control participants from the psychiatric outpatient clinic at National Cheng Kung University Hospital. Their severity of mood symptoms was measured according to the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). All study participants completed the childhood trauma questionnaire (CTQ), World Health Organization Quality of Life (WHOQOL) Scale and University of California, Los Angeles Loneliness Scale. Results: Compared with controls, patients with euthymic BD had significantly higher scores of HDRS (p < 0.01), YMRS (p < 0.001), CTQ (p < 0.001), loneliness scores (p < 0.001), but significantly lower WHOQOL scores (p < 0.001). In patients with euthymic BD, a significantly positive correlation was found between loneliness and CTQ scores (p < 0.001) and a significantly negative correlation was present between loneliness and WHOQOL scores (p < 0.001). These correlations were also present in the control group (p < 0.05 and p < 0.001). Conclusion: Euthymic BD patients had stronger feelings of loneliness than controls overall. In both euthymic BD and control patients, loneliness was positively correlated with childhood trauma and negatively correlated with quality of life. These findings warrant further investigations to strengthen the findings of the causal relationship between childhood trauma and loneliness.