Life stress and the course of early-onset bipolar disorder

University of Colorado, Boulder, CO, USA.
Journal of Affective Disorders (Impact Factor: 3.71). 05/2007; 99(1-3):37-44. DOI: 10.1016/j.jad.2006.08.022
Source: PubMed

ABSTRACT Studies of adult bipolar patients and adolescents with major depression indicate that life stress and mood symptoms are temporally and causally related to one another. This study examined whether levels of life stress predict levels of mood symptoms among bipolar adolescents participating in a treatment development study of family-focused psychoeducation and pharmacotherapy.
Bipolar adolescents (n=38) who reported a period of acute mood symptoms within the prior 3 months were recruited for a 1-year study of life stress. Clinician-administered evaluations were completed with adolescents and parents at 3-month intervals for up to 12 months, using the UCLA Life Stress Interview and the K-SADS Mania and Depression Rating Scales.
Chronic stress in family, romantic and peer relationships was associated with less improvement in mood symptoms over the study year. The frequency of severe, independent life events also predicted less improvement in mood symptoms. Higher levels of chronic stress in family and romantic relationships, and higher severity of independent events, were more strongly associated with mood symptoms among older adolescents. Results were independent of adolescents' psychosocial treatment regimens.
The majority of adolescents received family-focused psychoeducational treatment and all were being treated with psychotropic medication. The influence of life stress on mood symptoms may have been attenuated by intensive intervention.
Stress is linked to changes in mood symptoms among bipolar adolescents, although correlations between life events and symptoms vary with age. Chronic stress in family, romantic, and peer relationships are important targets for psychosocial intervention.

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    • "The reverse association, that mood predicts psychosocial outcomes, has also been found (Goldberg and Harrow, 2005). In BP youth, low maternal warmth and stress in family and romantic relationships are associated with faster relapse and longer time to symptom improvement (Geller et al., 2002, Geller et al., 2004, Kim et al., 2007). In BP adolescents, changes in family conflict and cohesion predict changes in mood symptoms over time (Sullivan et al., 2012). "
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    Journal of Nervous & Mental Disease 02/2015; 203(3). DOI:10.1097/NMD.0000000000000261 · 1.81 Impact Factor
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    • "Towards that end, family functioning is a particularly salient domain to examine in children and adolescents with psychopathology , particularly those with BD and ADHD. Studies have shown that children with BD have impairments in several familyrelated dimensions, including general family functioning, maternal warmth, expressed emotion, conflict, and family stress (Algorta et al., 2011; Belardinelli et al., 2008; Esposito-Smythers et al., 2006; Keenan et al., 2011; Kim et al., 2007; Miklowitz and Johnson, 2009; Sullivan and Miklowitz, 2010; Townsend et al., 2007). However, it is difficult to determine if family dysfunction is a trait characteristic of pediatric BD, or if it is state-dependent, corresponding to mood status (e.g., mania, depression, or euthymia) or Contents lists available at ScienceDirect journal homepage: "
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    Journal of Affective Disorders 05/2013; 150(3). DOI:10.1016/j.jad.2013.04.027 · 3.71 Impact Factor
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    • "There is evidence in unipolar depression that stressors predict both poorer clinical outcomes as well as greater social dysfunction over time (e.g., Cronkite et al., 1998). In the bipolar literature, several studies have examined the role of stressful life events and circumstances in bipolar episode recurrence (e.g., Cohen et al., 2004; Kim et al., 2007; Hammen and Gitlin, 1997; Swendsen et al., 1995; see Johnson and Roberts, 1995, for a review). Further, Johnson and Miller (1997) found that bipolar patients who experienced a recent major life event took more than 3 times longer to recover clinically from an episode than those who did not experience major events. "
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