Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 170, Issue -, Pages 166-171Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jad.2014.08.043
Keywords
Bipolar disorder; Life event; Stress; Mood disorders; Relapse
Categories
Funding
- Osterreichische Forschungsforderungsgesellschaft mbH (FFG)
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM)
- Instituto de Salud Carlos III, Spain
- Miguel Servet Research Contract [CP06/0359]
- [PI07/1276]
- [PI10/02622]
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Background: Life events may very well increase the likelihood of affective episodes in bipolar disorder, but prospective data on survival are inconsistent. Methods: The authors examined the prevalence of negative and goal-attainment life events within 6 months prior to the index episode and after the index episode and their impact on the risk of relapse. Two hundred twenty-two consecutively admitted [CD-10 bipolar I (n=126) and It (n=96) patients were followed-up naturalistically over a period of 4 years. Results: One-hundred thirty-eight (62.2%) of the patients had at least one life event 6 month before the index episode. Seventy patients (31.5%) experienced one, 48 (21.6%) two, and 20 (9.0%) three (or more) lift events. Regarding life events after the index episode, 110 (49.5%) patients had at least one life event. Fifty-four patients (24.3%) experienced one, 31 (140%) two, and 25 (11.3%) three (or more) life events. The number of life events was larger in patients with bipolar II disorder than in patients with bipolar I disorder (p=0.004). Using a Cox regression analysis, the risk of a depressive relapse in bipolar I patients was associated with the number of life events after the index episode (p=0.002). This was independent of the quality of the life event. Limitations: Standardized life event scales, defined dosages of drugs or blood sampling during all visits were not performed. Conclusions: Our data suggest a high and continuous number of life events prior to affective episodes. Life events after the index episode worsened the course of bipolar I patients with more depressive episodes. This underlines the importance of detection and treatment of emerging life events. (C) 2014 Elsevier B.V. All rights reserved.
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