Stress reactivity in bipolar patients and its relation to prior history of disorder

Am J Psychiatry. 1997 Jun;154(6):856-7. doi: 10.1176/ajp.154.6.856.

Abstract

Objective: Two questions were posed: Does stress precipitate episodes of bipolar I disorder, and does sensitivity to stress differ in episodes later in the course of illness compared to early ones?

Method: Fifty-two patients with bipolar I disorder were followed longitudinally for up to 2 years; clinical course was monitored, and interview assessments of life events were made every 3 months.

Results: The patients who had episodes of illness during follow-up had experienced significantly more severe stressors and more total stress in the preceding 6 months, and more total stress in the preceding 3 months, than those without episodes. Inconsistent with Post's stress "sensitization" hypothesis, patients with more prior episodes were more likely to have episodes following major stressors, and they relapsed more rapidly.

Conclusions: Stressors may precipitate episodes of bipolar illness, especially for patients with more prior episodes. Different versions of the stress sensitization model remain to be tested.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ambulatory Care
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Life Change Events*
  • Longitudinal Studies
  • Male
  • Models, Psychological
  • Recurrence
  • Survival Analysis