Childhood Maltreatment and Cognitive Functioning in Bipolar Disorder: A Systematic Review and Meta-Analysis

IF 4.7 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2026-04-05 Epub Date: 2025-05-06 DOI:10.1111/acps.13813

Natalia E. Fares-Otero, Anaid Pérez-Ramos, Ricardo Lopez-Escribano, Sara Martin-Parra, Luis Alameda, Sarah L. Halligan, Kamilla Woznica Miskowiak, Eduard Vieta

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引用次数: 0

Abstract

Aims

Characterising the association between childhood maltreatment (CM) and cognitive functioning in bipolar disorder (BD) is crucial for improving the understanding of how early environmental risk factors impact the presentation of the disorder. We conducted a systematic review and meta-analysis to estimate associations between overall and subtypes of CM, global cognition/IQ, and five cognitive domains in BD (attention/processing speed, verbal memory/learning, working memory, executive functions/verbal fluency, and social cognition), and to explore moderators/mediators in these associations.

Methods

A systematic search was performed on 24 June 2024 to identify published peer-reviewed articles in six databases (PROSPERO-CRD42023468641).

Results

From 780 identified records, 20 studies were included, comprising 2457 individuals with BD (M ± SD, age in years = 39.5 ± 9.7; 41.3% males; BD type I = 81.2%); 152 effect sizes were pooled in random-effect meta-analyses. Overall CM was negatively associated with global cognition/IQ, attention/processing speed, and verbal memory/learning (r = −0.14 to −0.18, p = 0.002 to < 0.001). Sexual/physical abuse and physical neglect were negatively associated with global cognition/IQ, working memory, and executive functions/verbal fluency (r = −0.07 to −0.18, p = 0.037 to < 0.001). Emotional abuse was negatively associated with working memory (r = −0.12, p = 0.002). Emotional neglect was unrelated to cognitive functions. CM (overall/subtypes) was unrelated to social cognition. Meta-regressions did not identify any consistent moderators. Narrative synthesis identified possible moderators/mediators. Associations were of small magnitude, and a limited number of studies assessing CM subtypes and cognitive functions are available.

Conclusion

CM exposure is associated with worse cognitive performance in people with BD, an effect observed across multiple maltreatment types and cognitive domains. Besides trauma-informed interventions, those with BD and CM require cognitive assessment and therapies to rehabilitate cognitive functioning.

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儿童虐待与双相情感障碍的认知功能：系统回顾和荟萃分析

目的描述儿童虐待（CM）与双相情感障碍（BD）认知功能之间的关系，对于提高对早期环境风险因素如何影响双相情感障碍表现的理解至关重要。我们进行了系统回顾和meta分析，以估计CM的总体和亚型、整体认知/智商和双相障碍的五个认知领域（注意/加工速度、言语记忆/学习、工作记忆、执行功能/言语流畅性和社会认知）之间的关联，并探索这些关联的调节因子/中介因子。方法于2024年6月24日系统检索6个数据库（PROSPERO-CRD42023468641）中已发表的同行评议文章。结果从780份确定的记录中纳入20项研究，包括2457例双相障碍患者（M±SD，年龄= 39.5±9.7，男性41.3%，I型BD = 81.2%）；在随机效应荟萃分析中汇总了152个效应量。总体CM与整体认知/智商、注意力/处理速度和言语记忆/学习呈负相关（r = - 0.14至- 0.18,p = 0.002至<； 0.001）。性/身体虐待和身体忽视与整体认知/智商、工作记忆和执行功能/语言流利度呈负相关（r = - 0.07至- 0.18,p = 0.037至<； 0.001）。情绪虐待与工作记忆呈负相关（r = - 0.12, p = 0.002）。情感忽视与认知功能无关。CM（总体/亚型）与社会认知无关。元回归没有发现任何一致的调节因子。叙述综合确定了可能的调节者/调解者。相关性较小，评估CM亚型和认知功能的研究数量有限。结论CM暴露与双相障碍患者较差的认知表现有关，这种影响在多种虐待类型和认知领域均有观察到。除了创伤知情干预，双相障碍和CM患者需要认知评估和治疗来恢复认知功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.