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Chronic stressors and trauma: prospective influences on the course of bipolar disorder

Published online by Cambridge University Press:  18 February 2013

A. Gershon ,
S. L. Johnson  and
I. Miller
A. Gershon*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
S. L. Johnson
Affiliation:
Department of Psychology, University of California, Berkeley, CA, USA
I. Miller
Affiliation:
Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
*
*Address for correspondence: A. Gershon, Ph.D., Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305-5717, USA. (Email: [email protected])
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Abstract

Background

Exposure to life stress is known to adversely impact the course of bipolar disorder. Few studies have disentangled the effects of multiple types of stressors on the longitudinal course of bipolar I disorder. This study examines whether severity of chronic stressors and exposure to trauma are prospectively associated with course of illness among bipolar patients.

Method

One hundred and thirty-one participants diagnosed with bipolar I disorder were recruited through treatment centers, support groups and community advertisements. Severity of chronic stressors and exposure to trauma were assessed at study entry with in-person interviews using the Bedford College Life Event and Difficulty Schedule (LEDS). Course of illness was assessed by monthly interviews conducted over the course of 24 months (over 3000 assessments).

Results

Trauma exposure was related to more severe interpersonal chronic stressors. Multiple regression models provided evidence that severity of overall chronic stressors predicted depressive but not manic symptoms, accounting for 7.5% of explained variance.

Conclusions

Overall chronic stressors seem to be an important determinant of depressive symptoms within bipolar disorder, highlighting the importance of studying multiple forms of life stress.

Keywords

Bipolar disorderdisease progressionprospective studiessocial environmentstress
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 12 , December 2013 , pp. 2583 - 2592
Copyright
Copyright © Cambridge University Press 2013 

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