The Relationship Between Post-Traumatic Stress Disorder (PTSD) and Symptom Severity in Middle-Aged Adults with Bipolar Disorder: A Systematic Review and Meta-Analysis

The comorbidity of Post-Traumatic Stress Disorder (PTSD) and Bipolar Disorder (BD) presents a significant clinical challenge, particularly in middle-aged adults (۴۰-۶۵ years) where age-related physiological and psychological changes may exacerbate symptom presentation. This meta-analysis aims to quantify the impact of PTSD on the severity of depressive and manic symptoms in this specific population. A systematic search of Google Scholar, PubMed, and ScienceDirect was conducted for studies published between ۲۰۲۰ and ۲۰۲۵, including both international and Persian sources. Data from five major studies involving over ۱,۲۰۰ participants were synthesized. Results indicate that middle-aged individuals with comorbid BD and PTSD exhibit significantly higher depressive symptom scores (Mean Difference [MD] = ۸.۷, ۹۵% CI: ۷.۹–۹.۵) and increased mania severity (MD = ۴.۹, ۹۵% CI: ۴.۱–۵.۷) compared to those with BD alone. Furthermore, PTSD was associated with a higher frequency of psychotic features and hospitalizations. These findings underscore the necessity of trauma-informed interventions and routine PTSD screening for middle-aged patients with bipolar disorder to mitigate long-term morbidity.

کلیدواژه ها:

**Bipolar Disorder ، PTSD ، Middle-aged Adults ، Symptom Severity ، Meta-analysis ، Trauma