Dr. Natalia E. Fares-Otero

Dr. Natalia E. Fares-Otero is a postdoctoral clinical researcher at the Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences, University of Barcelona. She is a doctor in psychobiology, trained neuropsychologist, and MS in biostatistics. In the trauma field, Dr. Fares-Otero has studied the cognitive-behavioural, biological and social factors that contribute to severe mental disorders following childhood maltreatment exposure (abuse and neglect), working with both national and international populations. She is particularly interested to identify potential intervention targets.

Bipolar disorder (BD) is among the leading causes of disability worldwide, with substantial impacts on individuals, their families, and society. There is a well-documented link between childhood maltreatment (CM, i.e., abuse or neglect) and poor mental and physical health. CM has consistently been shown to strongly increase the risk for BD. Furthermore, CM is a major risk factor for a worsening clinical course and severity of BD. Additionally, CM represents a risk factor for comorbidities mainly substance abuse and posttraumatic stress disorder, suicidal ideation and attempts. Moreover, CM is linked to impairments in various domains of social functioning in adults with BD. In addition to understanding, preventing, and treating the mental and physical consequences of CM in those with BD, it is equally critical to understand and strengthen patients’ social functioning interactions in the social environment and the ability to fulfil social roles during daily work and leisure-related activities with family, colleagues, friends and partners. Meta-analytic evidence and a conceptual framework illustrating associations between CM and social impairment in individuals with BD will be provided. To advance the field and develop effective interventions that strengthen social functioning in individuals with BD and a history of CM, future research needs to focus on identifying factors that underlie impaired social functioning and on the processes that mediate the positive health effects of positive relationships and intact social functioning and factors that appear to make individuals more resilient to poor social functioning in patients exposed to CM. Specific recommendations and methodological considerations for future research will be proposed. Finally, there is a compelling urgency for treatment adjustments, driven by the prevalence of treatment non-responses and the insufficient recognition of underlying etiological factors. Designing a tailored treatment that addresses biopsychosocial patient characteristics requires diagnostic assessments beyond symptom-based diagnostics, recognising etiological factors such as CM, neurobiological functions, and sex/gender-specific aspects. This will provide an opportunity to delve into the common phenomenon where individuals with BD who have experienced CM show limited response to standard pharmacologic and psychotherapeutic treatments. In addition to the standard treatment protocol and specific adjustments to the therapeutic alliance, the utilisation of trauma-focused approaches and additional skill-based strategies will be proposed to improve their social life and well-being. Utilising insights from the neurobiological impacts of CM in treatment significantly enhances our biopsychosocial understanding of the developmental roots of health and pathology. This understanding will catalyse fundamental advancements in treating BD among individuals with a history of CM.

• Fares-Otero, NE, Schalinski, I. (2024). "Social cognition in maltreated individuals: Do type and timing of maltreatment matter?" European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 81, 38–40. https://doi.org/10.1016/j.euroneuro.2023.12.011
• Fares-Otero, NE, et al. (2023). "Child maltreatment and resilience in adulthood: a protocol for a systematic review and meta-analysis". European Journal of Psychotraumatology, 14(2), 2282826. https://doi.org/10.1080/20008066.2023.2282826
• Fares-Otero, NE, <...> Vieta, E., & Martinez-Aran, A. (2023). "Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis". Acta Psychiatrica Scandinavica, 148(2), 142–164. https://doi.org/10.1111/acps.13557
• Fares-Otero, NE, Martinez-Aran, A. (2022). "Social Stress in Bipolar Disorder". European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 60, 22–24. https://doi.org/10.1016/j.euroneuro.2022.04.002