From Early Adversity to Adult Health: Quality-of-Life Consequences in A Mental Illness in Saudi Arabia

Objectives: Childhood trauma (CT) is prevalent among bipolar disorder (BD) patients and exacerbates clinical outcomes, which may impact the quality of life (QoL). This study explores the prevalence of CT and its association with QoL among BD patients in Saudi Arabia. Methods: Cross-sectional study conducted among adults with BD during the euthymic phase. Sample size was estimated using a single-proportion approach (target n=141), and participants recruited by convenience sampling of eligible outpatients. CT was assessed using the Childhood Trauma Questionnaire (CTQ), and QoL using the the Brief Quality of Life in Bipolar Disorder (Brief QoL.BD). Results: The CT prevalence was 90.1%, with physical neglect the most common type (78.7%). Mean QoL score was 36.2/60 (SD 10.7). Emotional neglect and emotional abuse had the most significant negative impact on QoL (mean differences: 9.6 points 95% CI: 6.4–12.8 and 6.4 points 95% CI: 3.0–9.9, respectively). In adjusted analyses, CT exposure, sex, age, and medication adherence were associated with QoL; the model explained 19% of QoL variability. Conclusion: The CT significantly impairs QoL in BD patients, particularly emotional neglect and abuse. Tailored interventions are essential for improving QoL in this population, particularly in culturally specific contexts such as the Middle East.