Abstract
BackgroundLife events play an important role in the onset and course of bipolar disorder. We will test the influence of life events on first and recurrent admissions in bipolar disorder and their interaction to test the kindling hypothesis.MethodsWe collected information about life events and admissions across the life span in 51 bipolar patients. We constructed four models to explore the decay of life event effects on admissions. To test their interaction, we used the Andersen-Gill model.ResultsThe relationship between life events and admissions was best described with a model in which the effects of life events gradually decayed by 25% per year. Both life event load and recurrent admissions significantly increased the risk of both first and subsequent admissions. No significant interaction between life event load and number of admissions was found.ConclusionsLife events increase the risk of both first and recurrent admissions in bipolar disorder. We found no significant interaction between life events and admissions, but the effect of life events on admissions decreases after the first admission which is in line with the kindling hypothesis.
Highlights
Life events play an important role in the onset and course of bipolar disorder
The exponentiated linear coefficients from the A-G model are interpreted as risk ratios relating the magnitude of a covariate to admission
We extended these previous findings by showing that the effect of life events on admissions did not change when events related to the disorder were excluded from the analyses
Summary
Life events play an important role in the onset and course of bipolar disorder. The diathesis-stress model serves to explore how non-biological or genetic traits (diatheses) interact with environmental influences (stressors) to trigger the onset of psychiatric disorders (Moffitt et al 2005; Harris 2001). Numerous studies have demonstrated that life events play a role in the onset and course of both unipolar depression and bipolar disorder (Bender and Alloy 2011; Brown and Harris 1989; Hillegers et al 2004; Hlastala et al 2000; Malkoff-Schwartz et al 1998). Bender and Alloy (2011) confirmed that the gold standard of life stress measurements is the Life Events and Kemner et al International Journal of Bipolar Disorders (2015) 3:6 Self-administered measures of stressful life events appear unreliable (Johnson 2005). Bender and Alloy (2011) confirmed that the gold standard of life stress measurements is the Life Events and Kemner et al International Journal of Bipolar Disorders (2015) 3:6
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