Childhood maltreatment, exercise and transition to bipolar disorder among major depressive disorder patients
Bibliographic record
Abstract
Early and accurate identification and management of bipolar disorders (BDs) among major depressive disorders (MDDs) in clinical practice would place these patients in progressive early-onset bipolar care. The associations between childhood maltreatment, exercise and transition from MDD to BD remain unclear. To determine whether MDD patients reporting childhood maltreatment are at an increased risk of transition to BD. The secondary objective is to evaluate the moderating effects of exercise on the association. This prospective cohort study with a maximum follow-up of four years was based on the Depression Cohort in China. 1392 MDD with 18-65 years of age were enrolled between March 2019 and November 2023 after diagnosis by trained psychiatrists using the Mini-International Neuropsychiatric Interview and 1034 with complete data were finally included in the primary analysis. The Childhood Trauma Questionnaire-Short Form and exercise were collected at baseline, and clinician referrals for BD were confirmed at follow-up. Of the 1034 MDD patients included, the mean(SD) age was 28.32(7.00) years, and 714(69.1%) were women. 58 transitions to BD (39.64 per 1000 person years) were reported among MDD patients. Childhood emotional abuse (aHR, 1.05; 95%CI, 1.00-1.11; P = 0.04) and sexual abuse (aHR, 1.15; 95%CI, 1.04-1.27; P = 0.008) were positively associated with transition to BD. Stratified analyses showed that childhood emotional abuse (aHR, 1.08; 95%CI, 1.02-1.14; P = 0.007) was associated with transition to BD among patients without habitual exercise, but not among those with habitual exercise. Childhood emotional abuse and sexual abuse may be significant risk factors for the transition from MDD to BD, while exercise may partly offset the risk effects of emotional abuse and this transition. MDD patients who reported related childhood maltreatment, their families and health professionals should monitor closely and screen frequently for the possible emergence of BD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".