Stressful life events in older bipolar patients

Abstract

Objective-Theories about the impact of stressful life events (SLE) in bipolar disorder have focused on their role early in the disease. Few studies have examined SLE in older bipolar patients. We wanted to assess the impact of SLE in late life bipolar disorder Methods-We evaluated negative SLE experienced by older bipolar subjects compared with younger bipolar subjects and older controls for number, type, and their association with phase of illness, age of onset, and previous episodes.Results-Both younger and older bipolar subjects have more SLE than similarly aged controls. There was no significant difference in the number of stressors that younger and older bipolar subjects experienced, based on mood state, previous episodes, or age-of-onset. Both older and younger depressed bipolar subjects reported more SLE in the previous 12 months compared with those in a manic state.Conclusions-Negative SLE are much more prevalent in bipolar patients compared with agematched controls, and continue to be frequent in later life.

The Influence of Trauma, Life Events, and Social Relationships on Bipolar Depression

“…The most careful research has not provided much support for the idea that later episodes can be set in motion by less severe events (27). Rather, older individuals with bipolar disorder, like those who are younger, seem to experience a very high rate of serious life events (28). …”

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

“…Beyer et al (2008) examined whether life event rates in BD differ as a function of current age or age of onset. Given that they did not evaluate temporal precedence or independence of life events over the retrospective observation interval, the study was not technically a test of the kindling model.…”

“…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).…”

Trastorno bipolar geriátrico

“…La enfermedad cerebrovascular y otros trastornos neurológicos pueden contribuir también a producir la vulnerabilidad al trastorno bipolar, sobre todo cuando las lesiones cerebrales comprometen la integridad de los circuitos neuronales límbico, estriado y cortical prefrontal en los ancianos 18,[24][25][26][27] . Los factores psicosociales, incluidos los eventos vitales negativos, como una pérdida temprana o los traumas en la infancia y la adolescencia, pueden aumentar la vulnerabilidad al trastorno bipolar en una fase posterior de la vida 28 .…”