Life events and bipolar disorder

In the Netherlands, bipolar disorder (also known as manic-depressive illness) is diagnosed in approximately 2% of the population. The disorder is characterized by alternating periods of raised activity and (manic) mood and periods of reduced activity with lowered (depressed) mood. Bipolar disorder occurs more frequently in families, which is an indication that genes play a role in the development of the disorder. As with most psychiatric disorders, their origin lies in an interaction between genes and environment. Which factors play a role in the development of this disease is still an ongoing quest. In this thesis, four studies explore possible causal factors such as stress, abnormalities in hippocampal volume and activation of the immune system and their interactions with each other. Stress is one of the factors which is often associated with the aetiology of psychiatric disorders, as well as with bipolar disorder. In conclusion, the most important finding of this study is the influence that stressful life events have on the onset and course of bipolar disorder. We found evidence that stressful life events influence both the risk of onset of mood episodes as well as the risk of psychiatric submission. The impact of life events was greater on the first mood episode or submission than on any subsequent episodes or submissions. Although more research is needed, the above findings contribute to our understanding of the role of stress in bipolar disorder and provide potential tools for (early) intervention.

Dissertation: http://hdl.handle.net/11370/14fff752-69ff-4169-919f-789592d52382