Childhood Maltreatment in the Context of Familial Bipolar I Disorder Risk Predicts Major Depressive Disorder in Adolescents

Objective To quantify associations between childhood maltreatment and emerging major depressive disorder (MDD) in adolescents/young adults with and without a first-degree family history of bipolar I disorder. Method A total of 116 youths 14 to 21 years old were classified into a high-risk group (n = 58) based on at least 1 first-degree relative diagnosed with bipolar I disorder and a low-risk group (n = 58) based on no first- or second-degree family history of bipolar disorder. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire–Short Form (CTQ-SF). Psychiatric diagnoses were established with semistructured interviews. Logistic regression tested interactions between childhood maltreatment and familial risk, controlling for age and sex, as predictors of MDD. Results Half of participants in the high-risk group exhibited current or past MDD compared with 24% of the low-risk group. Regression models showed that each 1-point increase in CTQ-SF total score was associated with a 7% increase in the odds of MDD (odds ratio [OR] = 1.07, 95% CI 1.01-1.17, p = .004). High-risk status conferred approximately 3 times greater odds of MDD vs low-risk status (OR = 3.04, 95% CI 1.14–8.43, p = .03). Each year of age increased risk of MDD by 34% (OR = 1.34, 95% CI 1.09–1.67, p = .01). The childhood maltreatment × familial risk interaction was not significant ( p > .6). Conclusion Childhood maltreatment and familial risk for bipolar I disorder independently increase the risk of MDD. Mitigating either risk factor independently could meaningfully reduce depression risk in at-risk youth. Plain language summary This study investigated associations between childhood maltreatment and development of major depressive disorder (MDD) symptoms in 116 adolescents (ages 14-21 years) with (high-risk [HR]) and without (low-risk [LR]) a first-degree family member diagnosed with bipolar I disorder. Half of HR participants exhibited current or past MDD, compared with 24% of the LR group. The authors also found that higher total trauma questionnaire score, HR status, and older age increased the odds of having MDD. Findings suggest that childhood maltreatment and familial risk for bipolar disorder are associated with major depression risk, highlighting opportunities for screening and early intervention efforts in offspring of adults living with bipolar 1 disorder. Diversity & Inclusion Statement We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.