Day: February 24, 2011
At the same time, throughout psychiatry, there has been a continuing debate over the status of aggressive behavior in children and in relation to other disorders. Lee and Galynker3 reported that “just under 50% of people with bipolar disorder have some history of violent behavior.” Violence can occur in manic or in depressive states, or even in euthymic moods. They saw a close and compounding relationship between childhood trauma and violence in adult Bipolar Affective Disorder (BAD): “A history of 2 or more types of trauma has been associated with a 3-fold increased risk of bipolar disorder, as well as a worse clinical course that includes early onset, faster cycling, and increased rates of suicide.” Early trauma complicates adult affective disorder by predisposing to substance abuse, criminality, and personality disorder. In general, early onset of aggressive behavior indicates a poorer prognosis, and not just for the affective disorder. So what is the disorder, and what should be treated?