The psychosocial context of bipolar disorder: Environmental, cognitive, and developmental risk factors

Alloy, Lauren B.; Abramson, Lyn Y.; Urošević, Snežana; Walshaw, Patricia D.; Nusslock, Robin; Neeren, Amy M.

doi:10.1016/j.cpr.2005.06.006

Cited by 175 publications

(171 citation statements)

References 141 publications

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“…No direction is predicted for number of previous episodes, or psychotic symptoms since earlier studies have yielded conflicting results (11,6). We predicted a positive association between adverse childhood events (ACE), stress, age at onset with outcome, similarly to previous studies (19,20,21).…”

Section: Introductionsupporting

confidence: 65%

“…Since between 30 to 60% of patients do not attain full functioning following treatment, exploration of additional factors correlated with persistent impairment in BD is warranted (10). Research investigating psychosocial factors and comorbidity, such as the number of previous episodes, psychotic symptoms, and outcome have been variable in determining effects on outcome (11,6,12,13,14). Social support has been identified as a variable associated with positive outcome, particularly with regard to depressive symptoms (18).…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial Factors Associated With Recovery In Bipolar Disorder

Rapport

Lynch

McGrady

et al. 2015

JDT

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Bipolar disorder (BD) is a chronic psychiatric illness impacting patient functioning and quality of life. Medication produces improvement in many patients and remission in some, but there is minimal understanding about why some patients improve and others do not. Our goal was to identify demographic, psychosocial and comorbid variables associated with outcomes in BD. Charts of 121 outpatients treated with medication and supportive psychotherapy were reviewed. Forty four percent attained euthymia for 12 months while 56% did not. Poorer outcome was associated with economic stress, missed appointments, life stress, and presence of pain (p < 0.05). Those employed were more likely to improve (p < 0.02). Patients with BP-II reported more frequent life stressors, headache and use of alcohol (p <0.05) and were less likely to achieve euthymia than BP-I. Gender, education, and co-morbid medical illness did not affect results. Our findings suggest that poorer outcome is related to psychosocial factors. Increased attention to these variables may increase providers' ability to manage challenging patients with BD.

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Section: Introductionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Psychosocial Factors Associated With Recovery In Bipolar Disorder

Rapport

Lynch

McGrady

et al. 2015

JDT

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“…Recent study with using Cox regression model in the 12-month followup period study, has reported no significant differences in recovery from hospitalization between patients with mania compared with mixed bipolar disorder and another study found that bipolar women experienced an equal greater risk of recurrence than men [45]. Negative life event has not significant effect on outcome although most studies with-out considering frailty have found that negative life events precede episodes of bipolar individuals [46]. It shows that when we consider individuals heterogeneity in model this factor lose its efficiency.…”

Section: Discussionmentioning

confidence: 99%

Identifying Some Risk Factors of Time to Recurrent Relapses in Bipolar I Disorder Patients using Frailty Model of Survival Analysis

Taheri¹,

Khodaie‐Ardakani²

2016

J Psychiatry

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Journal of Psychiatry AbstractObjective: Bipolar I disorder patients often experience relapse once and even more with no limit on number of relapses. The time to relapses of these patients are rarely studied particularly considering heterogeneity across individuals. The aim of this study was to identify some risk factors of time to recurrent relapses in bipolar I disorder patients with a recurrent event model in survival analysis.Methods: In a retrospective longitudinal study, data of medical records of 526 bipolar I disorder patients who had referred to Razi Psychiatric hospital in Tehran from 1993 to 2011 with at least one relapse, with-out relapse in other hospitals or home in this duration, were investigated and time to recurrent relapses were collected in months. Semiparametric penalized frailty model which consider whit-in subject correlation and heterogeneity across individuals, was applied to identify the risk factors of recurrent time to relapses.Results: Significant frailty parameter (p<0.001) prove presence of heterogeneity among data. In frailty model the effects of substance abuse (p=0.041), regular fluctuation (p=0.002) and marital status (p=0.009) were significant on the hazard of recurrent times to relapses but other variables showed no significant effect.Conclusions: Substance abuse, marital status and RF are important risk factors in order to plan for postpone the time to next relapses. More studies are required to clear out the effect of other covariates with this model.

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“…Similarly, there are suggestions that life events, cognitive vulnerability, the cognitive vulnerability-stress combination, poor parenting, and maltreatment play a role in the onset and course of EOBP (Alloy et al 2005). Low socioeconomic status (SES), stressful life events, cognitive style, negative, hostile parenting as reflected in low maternal warmth, poor social supports, parent divorce and conflict, low levels of family cohesion and organization, increased family conflict, and physical and sexual abuse have all been identified as risk factors for development or exacerbation of EOBP (Leverich et al 2002;Tillman et al 2003;Alloy et al 2005;Birmaher et al 2006;Kim et al 2007).…”

Section: Carlson Et Almentioning

confidence: 99%

AACAP 2006 Research Forum—Advancing Research in Early-Onset Bipolar Disorder: Barriers and Suggestions

Carlson

Findling

Post

et al. 2009

Journal of Child and Adolescent Psychopharmacology

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Objective: The 2006 Research Forum addressed the goal of formulating a research agenda for early-onset bipolar disorder (EOBP) and improving outcome by understanding the risk and protective factors that contribute to its severity and chronicity. Method: Five work groups outlined barriers and research gaps in EOBP genetics, neuroimaging, prodromes, psychosocial factors, and pharmacotherapy. Results: There was agreement that the lack of consensus on the definition and diagnosis of EOBP is the primary barrier to advancing research in BP in children and adolescents. Related issues included: the difficulties in managing co-morbidity both statistically and clinically; acquiring adequate sample sizes to study the genetics, biology, and treatment; understanding the EOBP's developmental aspects; and identifying environmental mediators and moderators of risk and protection. Similarly, both psychosocial and medication treatment strategies for children with BP are hamstrung by diagnostic issues. To advance the research in EOBP, both training and funding mechanisms need to be developed with these issues in mind. Conclusions: EOBP constitutes a significant public health concern. Barriers are significant but identifiable and thus are not insurmountable. To advance the understanding of EOBP, the field must be committed to resolving diagnostic and assessment issues. Once achieved, with adequate personnel and funding resources, research into the field of EOBP will doubtless be advanced at a rapid pace.

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The psychosocial context of bipolar disorder: Environmental, cognitive, and developmental risk factors

Cited by 175 publications

References 141 publications

Psychosocial Factors Associated With Recovery In Bipolar Disorder

Psychosocial Factors Associated With Recovery In Bipolar Disorder

Identifying Some Risk Factors of Time to Recurrent Relapses in Bipolar I Disorder Patients using Frailty Model of Survival Analysis

AACAP 2006 Research Forum—Advancing Research in Early-Onset Bipolar Disorder: Barriers and Suggestions

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