Developmental vulnerabilities to the onset and course of bipolar disorder

Abstract

Different types of psychosocial stressors have long been recognized as potential precipitants of both unipolar and bipolar affective episodes and the causative agents in posttraumatic stress disorder (PTSD). New preclinical data have revealed some of the neurobiological mechanisms that could convey the long-term behavioral and biochemical consequences of early stressors. Depending on the timing, quality, quantity, and degree of repetition, maternal deprivation stress in the neonatal rodent can be associated with lifelong anxiety-like behaviors, increases in stress hormones and peptides, and proneness to drug and alcohol administration, in association with acute changes in the rate of neurogenesis and apoptosis (preprogrammed cell death) and decrements in neurotrophic factors and signal transduction enzymes necessary for learning and memory. Patients with bipolar illness who have a history of early extreme adversity (physical or sexual abuse in childhood or adolescence), compared with those without, show an earlier onset of illness, faster cycling frequencies, increased suicidality, more Axis I and Axis II comorbidities (including alcohol and substance abuse), and more time ill in more than 2 years of prospective follow-up. These findings are subject to a variety of interpretations, but to the extent that the more severe course of bipolar illness characteristics are directly and causally related to these early stressful experiences, early recognition and treatment of high-risk children could be crucial in helping to prevent or ameliorate the long-term adverse consequences of these stressors.

Psychosocial functioning of adolescents with and without paediatric bipolar disorder

“…Further, there was a greater likelihood of past reports of trauma as compared with the controls, a finding also documented in other BD populations (Post et al, 2001;Marchand et al, 2005). Interestingly, there was an equal reporting of traumatic events across family constellation (single versus intact homes) within the BD group suggesting that BD youth are at risk for abuse, regardless of the specific constellation in which they are reared.…”

Role of Parenting and Maltreatment Histories in Unipolar and Bipolar Mood Disorders: Mediation by Cognitive Vulnerability to Depression

“…An examination of developmental experiences in mood disorders is important, as researchers have argued that there are potential long-lasting consequences of early adverse experiences on neurochemistry, brain structure, and affective behavior (Leverich et al, 2002;Post, Leverich, Xing, & Weiss, 2001). In addition, other researchers argue that maltreatment affects emotion regulation, as it interferes with a child's ability to regulate their emotions by promoting chronic arousal (Cloitre, 1998).…”

RNA Interference: A New Hope in Understanding and Treatment of Psychiatric Disorders

“…Many studies to date have attempted to clarify the issue by different means, such as descriptive, genetic, etc. In this respect the serotonergic system, circadian rhythms, developmental and environmental factors have been reported to have a role in mood and anxiety disorders (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29).…”

“…Early environmental factors can affect the development of psychopathology in adulthood (22,24,25,29). One of the molecules thought to be important for this process is alpha adrenergic receptor-2 (α-2R).…”