EXPLORING THE IMPACT OF CHILDHOOD NEGLECT ON COGNITIVE FUNCTION IN PATIENTS WITH BIPOLAR DISORDER

Abstract Background Bipolar disorder (BD) is a severe mental disorder associated with neurocognitive deficits. The exposure to childhood trauma experiences is also linked to poorer cognitive performance. However, there is limited reporting on the distinct compositions of childhood trauma in BD and their specific impacts on cognitive performance. Methods In this cross-sectional study, we utilized the Brief Assessment of Cognition in Affective Disorders (BAC-A) to evaluate cognitive performance and the Chinese version of the Childhood Trauma questionnaire-short form (C-CTQ-SF) to assess childhood trauma experiences in a sample of 55 euthymic BD patients. We applied Two-Step cluster analysis to dissect their childhood trauma experiences, revealing distinct clusters: a low-trauma group, a neglect-focus group, and a multiple trauma experience group. We compared cognitive function among these three clusters and employed a generalized linear model to assess the impact of childhood neglect trauma on cognitive domains. Results The neglect-focus cluster exhibited notably high levels of exposure to physical and emotional neglect (41.8%). Moreover, BD patients in this cluster performed even worse on the BAC-A compared to patients in the multiple trauma cluster, particularly in working memory and processing speed. Using the low trauma cluster as a reference, the neglect-focus group revealed a significant negative effect on the composite score (ß = -0.904, p = 0.025) and working memory (ß = -1.150, p = 0.002), after adjusting for confounding factors. Conclusions Distinct patterns of childhood trauma experience are observed in BD patients and are associated with different cognitive profiles. Early exposure to neglect-focus trauma is linked to the poorest cognitive performance in the current study. Further studies investigating the intensity of neglect, as well as individual resilience and coping mechanisms in BD, are warrant.