Life events and early and late onset of bipolar disorder

Abstract

Forty-six subjects with bipolar disorder and their relatives and friends were interviewed in depth about life events preceding the first and the latest episode of the subject's affective illness. Twenty years of age was the cutting point for dividing the sample into early- and late-onset groups. The late-onset group reported the occurrence of significantly more stressful life events before the first and before the latest episode of affective illness than the early-onset group did.

Life stress and kindling in bipolar disorder: Review of the evidence and integration with emerging biopsychosocial theories

“…Thus, among three retrospective studies conducting within-subjects comparisons of first and most recent episodes, one supported the kindling model (Glassner et al, 1979), another failed to support it (Bidzinska, 1984), and a third failed to support it, but identified group differences in stress reactivity according to age of BD onset (Glassner & Haldipur, 1983). All studies examined event frequency rather than impact, and none allowed for comparison of sensitization vs. autonomy models due to the absence of a systematic assessment of minor forms of stress.…”

“…Results indicated that a higher proportion of initial episodes were preceded by at least one stressful event, as compared to recent index episodes. Using the same methods, these researchers (Glassner & Haldipur, 1983) found that neither early- nor late-onset BD patients experienced a significant decline in life event frequency prior to their initial vs. most recent episodes. The pattern of results did not support a kindling model, but suggested that late-onset patients experience a higher frequency of life events prior to episodes across the course of their disorder, as compared to those with an earlier onset.…”

“…The pattern of results did not support a kindling model, but suggested that late-onset patients experience a higher frequency of life events prior to episodes across the course of their disorder, as compared to those with an earlier onset. Glassner and Haldipur (1983) hypothesized that patients with earlier onsets could be more genetically predisposed to BD, which could account for differences in stress reactivity.…”

“…First, BD is a heterogeneous condition, and inclusion criteria have varied across studies. Some researchers included only participants with a diagnosis of BD I (Ambelas, 1979, 1987; Beyer et al, 2008; Dienes et al, 2006; Dunner et al, 1979; Glassner & Haldipur, 1983; Glassner et al, 1979; Hammen & Gitlin, 1997; Hlastala et al, 2000; Kennedy, 1983), whereas others included BD II participants (Bidzinska, 1984; Ehnvall & Ågren, 2002; Johnson et al, 2000a; Swendsen et al, 1995). In some cases, researchers excluded rapid cyclers (Ambelas, 1979; Hlastala et al, 2000) or those with “too many episodes to count” (Dienes et al, 2006).…”

Kindling of Life Stress in Bipolar Disorder: Effects of Early Adversity

“…Early studies used cross-sectional designs comparing rates of life events in patients experiencing a first episode versus a recurrence (Ambelas, 1979, 1987; Perris, 1984) or retrospective designs that examined the frequency of life events occurring prior to participants’ earlier vs. later episodes (Bidzinska, 1984; Dunner et al, 1979; Ehnvall & Ågren, 2002; Johnsonet et al, 2000) with some not finding support for a kindling effect in BD (Kennedy et al, 1983; Glassner & Haldipur, 1983). These mixed findings were attributed to long intervals for recall and the use of stress checklists that may be biased by participants’ current mood or fallible memory.…”