Stress reactivity in bipolar patients and its relation to prior history of disorder
Abstract
Objective Two questions were posed: Does stress precipitate episodes of bipolar I disorder, and does sensitivity to stress differ in episodes later in the course of illness compared to early ones? Method Fifty-two patients with bipolar I disorder were followed longitudinally for up to 2 years; clinical course was monitored, and interview assessments of life events were made every 3 months. Results The patients who had episodes of illness during follow-up had experienced significantly more severe stressors and more total stress in the preceding 6 months, and more total stress in the preceding 3 months, than those without episodes. Inconsistent with Post's stress "sensitization" hypothesis, patients with more prior episodes were more likely to have episodes following major stressors, and they relapsed more rapidly. Conclusions Stressors may precipitate episodes of bipolar illness, especially for patients with more prior episodes. Different versions of the stress sensitization model remain to be tested.
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Stress can exacerbate symptoms of schizophrenia and bipolar disorder.
“Stress can also exacerbate the symptoms of schizophrenia27,28 and bipolar disorder by, for example, switching patients from a period of normalcy (euthymia) into a manic state29.”
From Stress signalling pathways that impair prefrontal cortex structure and function (2009) · cites this paper as [29]
Stress exacerbates mental illness-for example, the initial descent into schizophrenia or the switch from euthymia to illness in bipolar disorder.
“It has been appreciated for many years that stress exacerbates mental illness36—for example, the initial descent into schizophrenia37 or the switch from euthymia to illness in bipolar disorder38.”
From Stress weakens prefrontal networks: molecular insults to higher cognition (2015) · cites this paper as [38]
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- Authors
- Hammen, C. L., & Gitlin, M. J.
- Affiliations
- University of California, Los Angeles (US)
- ORCID
- Michael J Gitlin
- Venue
- American Journal of Psychiatry
- Published
- 1997-06-01
- Volume
- 154
- Issue
- 6
- Pages
- 856-857
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2442363320
- Cited by
- 138
- References
- 0
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 8 · 2014: 6 · 2013: 9 · 2012: 4
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar I disorder, stress reactivity, life events, relapse, longitudinal follow-up, stressors
- MeSH terms
- Adult, Ambulatory Care, Bipolar Disorder, Female, Follow-Up Studies, Humans, Life Change Events, Longitudinal Studies, Male, Models, Psychological, Recurrence, Survival Analysis
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