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The role of life events and psychological factors in the onset of first and recurrent mood episodes in bipolar offspring: results from the Dutch Bipolar Offspring Study

Published online by Cambridge University Press:  13 April 2015

S. M. Kemner ,
E. Mesman ,
W. A. Nolen ,
M. J. C. Eijckemans  and
M. H. J. Hillegers
S. M. Kemner
Affiliation:
Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
E. Mesman
Affiliation:
Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
W. A. Nolen
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
M. J. C. Eijckemans
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
M. H. J. Hillegers*
Affiliation:
Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
*
*Address for correspondence: M. Hillegers, Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, A00.241, PO Box 85500, 3508 GA Utrecht, The Netherlands. (Email: [email protected])
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Abstract

Background

Life events are an established risk factor for the onset and recurrence of unipolar and bipolar mood episodes, especially in the presence of genetic vulnerability. The dynamic interplay between life events and psychological context, however, is less studied. In this study, we investigated the impact of life events on the onset and recurrence of mood episodes in bipolar offspring, as well as the effects of temperament, coping and parenting style on this association.

Method

Bipolar offspring (n = 108) were followed longitudinally from adolescence to adulthood. Mood disorders were assessed with: the Kiddie Schedule of Affective Disorders and Schizophrenia – Present and Lifetime Version or the Structured Clinical Interview for DSM-IV Axis I disorders; life events with the Life Events and Difficulties Schedule; and psychological measures using the Utrecht Coping List, Temperament and Character Inventory and short-EMBU (memories of upbringing instrument). Anderson–Gill models (an extension of the Cox proportional hazard model) were utilized.

Results

Life events were associated with an increased risk for first and, although less pronounced, subsequent mood episodes. There was a large confounding effect for the number of previous mood episodes; findings suggest a possible kindling effect. Passive coping style increased the risk of mood episode onset and recurrent episodes, but also altered the effect of life events on mood disorders. Harm avoidance temperament was associated with mood episode recurrence.

Conclusions

Life events are especially a risk factor in the onset of mood disorders, though less so in recurrent episodes. Psychological features (passive coping and harm-avoidant temperament) contribute to the risk of an episode occurring, and also have a moderating effect on the association between life events and mood episodes. These findings create potential early intervention strategies for bipolar offspring.

Keywords

Bipolar disorderbipolar offspringcopinglife eventsmood disorders
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 12 , September 2015 , pp. 2571 - 2581
Copyright
Copyright © Cambridge University Press 2015 

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