The Effect of Traumatic Events on the Longitudinal Course and Outcomes of Youth with Bipolar Disorder

•Lifetime traumatic events were associated with poor course among bipolar youth•Trauma during recovery periods was associated with increased recurrence risk•Trauma was related with changes in mood symptoms, suicidality and comorbidities•Mood course, especially hypo/mania, meaningfully worsened after abuse occurrence•Causality cannot be inferred giving the approximate dates of traumatic events Background: Exposure to severe Traumatic Events (TEs) has been associated with poor course and outcomes among individuals with Bipolar Disorder (BD). However, there is limited research on TEs among youth with BD, and few studies are longitudinal. This study prospectively followed a large sample of BD youth, examining the associations of lifetime TEs with their mood and functioning. Methods: BD participants (n=375; mean age=17; range 8-25y) were assessed, on average, every 7 months for a median 8.7 years. Psychopathology and lifetime trauma history were prospectively evaluated using the Longitudinal Interval Follow-Up Evaluation, and a traumatic events screening. Results: Accounting for covariates, participants with one or more lifetime TEs (84%) showed earlier BD onset, poorer psychosocial functioning, worse mood symptoms, and more suicidal ideation, comorbidities, and family psychopathology than those without TEs. TEs during recovery periods increased recurrence risk (p