Effects Of Childhood Trauma On Emotional Cogniton In Euthymic Bipolar Disorder

Background:Bipolar disorder(BD)is the result of genetic-stress comprehensive effect.Environmental factors,especially early trauma events,play an important role in the development of bipolar disorder,which affects the clinical expression of disease and become one of the risk factors.And the bipolar disorder has become a serious medical and social problem.75% of patients of bipolar disorder can not return to normal level.And the decline of social function level is closely related to social cognition,especially emotional cognition.The impact of childhood trauma on the clinical expression and emotional cognitive function of the euthymic bipolar disorder is not yet clear.Objective: To explore the effect of childhood trauma on the cognitive function of patients ineuthymic bipolar disorder.Methods: Seventy-two patients ineuthymic bipolar disorder and 70 cases of healthy controls were enrolled from the psychiatric outpatient department of Hebei Medical University First Hospital from March 2015 to December 2016,we collected general information and social psychology data,to assess childhood trauma and emotional cognitive function of euthymic bipolar patients,using facial affect recognition.we analysis of six basis emotional face,eg happy,sad,anger,disgust,fear and surprise recognition accuracy.The SPSS21.0 statistical software was used for statistical analysis.The statistical description of the measurement data is expressed as mean ± standard deviation,Comparison between the two groups were used for t-test or nonparametric test.The statistical description of counting data used the constituent ratio and were analyzed byχ2 test.The influencing factors of childhood trauma to affect recognition was analyzed by stepwise linear regression method.Results:1 The correct rate of sadness in euthymic patients of bipolar disorder was 53.5%,anger was 52.0%,happy was 89.8%,surprise was 64.6%,fear was 35.9% and disgust was 36.4%,respectively.The correct rate in healthy control group of sadness was 60.9%,anger was 58.1%,happy was 95.5%,surprised wasn68.7%,disgust was 43.3%,fear was 30.9%;The two groups on correctness of emotional cognition was significant,sad(t=-2.424,P=0.017),anger(t=-2.018,P=0.046),happy(t=-3.492,P=0.001),fear(t=-3.331,P=0.001)and disgust(t=-2.596,P=0.011),respectively.2 The two groups between bipolar disorder and healthy control in t he childhood trauma questionnaire(t=5.702,P=0.000),emotion abuse(t=3.146,P=0.002),Emotion neglect(t=5.637,P=0.000),Sexual abuse(t=2.277,P=0.025),Physical neglect(t=3.179,P=0.002)and Physical abuse(t=3.270,P=0.001)were statistically significant.3 Ineuthymic bipolar disorder group,the patients with childhood tra uma(any type of trauma)of anger face recognition accuracy is poor(t=-2.021,P=0.048),which was statistically significant;the accuracy of the h appy face recognition was significantly lower(t=-2.027,P=0.041),and the accuracy of the surprised face was significantly lower than that of the control group(t=-2.019,P=0.049),statistically significant.4 Bipolar disorder group,using stepwise linear regression analysis,in the α in = 0.05,α out = 0.10 level,the factors of sadness recognitio n correct rate are marriage(t=-2.804,P=0.007),Antipsychotic drug types(t=-3.073,P=0.003)and life events(t=2.761,P=0.008);the factors of anger recognition correct rate are the number of mania(t=-2.453,P=0.017)an d emotional neglect(t=-2.205,P=0.032);the factors of happy recognition correct rate only emotion neglect(t=-2.030,P=0.047);The effect factors o f surprise recognition correct rate are sexual abuse(t=2.308,P=0.025)an d marital status(t=-2.007,P=0050);The effect factors of fear recognition correct rate is YMRS cores(t=-2.203,P=0.032);the factors of disgust c orrect rate are psychiatric symptoms(t=2.687,P=0.010)and body mass i ndex(t=-2.310,P=0.025).Conclusions:1 Patients in euthymic bipolar disorder still have specific facial affect recognitive impairments.2 The patients with childhood trauma in bipolar disorder experienced a wide range and severity of childhood trauma.3 The patients in euthymic bipolar disorder who experienced childhood trauma,remnanted cognitive symptoms obviously,especially the influence of emotion neglect on the recognition of anger and happy was serious,and there was dose-effect relationship.