Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis

Br J Psychiatry. 2016 Dec;209(6):454-459. doi: 10.1192/bjp.bp.115.179655. Epub 2016 Oct 6.


Background: The relationship between childhood adversity and bipolar affective disorder remains unclear.

Aims: To understand the size and significance of this effect through a statistical synthesis of reported research.

Method: Search terms relating to childhood adversity and bipolar disorder were entered into Medline, EMBASE, PsycINFO and Web of Science. Eligible studies included a sample diagnosed with bipolar disorder, a comparison sample and a quantitative measure of childhood adversity.

Results: In 19 eligible studies childhood adversity was 2.63 times (95% CI 2.00-3.47) more likely to have occurred in bipolar disorder compared with non-clinical controls. The effect of emotional abuse was particularly robust (OR = 4.04, 95% CI 3.12-5.22), but rates of adversity were similar to those in psychiatric controls.

Conclusions: Childhood adversity is associated with bipolar disorder, which has implications for the treatment of this clinical group. Further prospective research could clarify temporal causality and explanatory mechanisms.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult Survivors of Child Adverse Events*
  • Bipolar Disorder / etiology*
  • Humans