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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
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
*Corresponding
* 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: M.H.J.Hillegers@umcutrecht.nl)

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Alloy, LB, Reilly-Harrington, NA, Fresco, DM, Whitehouse, WG, Zechmeister, JS (1999). Cognitive styles and life events in subsyndromal unipolar and bipolar disorders: stability and prospective prediction of depressive and hypomanic mood swings. Journal of Cognitive Psychotherapy 13, 2140 Google Scholar
Altamura, AC, Mundo, E, Cattaneo, E, Pozzoli, S, Dell'osso, B, Gennarelli, M, Vergani, C, Trabattoni, D, Arosio, B, Clerici, M (2010). The MCP-1 gene (SCYA2) and mood disorders: preliminary results of a case–control association study. Neuroimmunomodulation 17, 126131.CrossRefGoogle ScholarPubMed
Arrindell, WA, Emmelkamp, PM, Brilman, E, Monsma, A (1983). Psychometric evaluation of an inventory for assessment of parental rearing practices. A Dutch form of the EMBU. Acta Psychiatrica Scandinavica 67, 163177.CrossRefGoogle ScholarPubMed
Arrindell, WA, Richter, J, Eisemann, M, Garling, T, Ryden, O, Hansson, SB, Kasielke, E, Frindte, W, Gillholm, R, Gustafsson, M (2001). The short-EMBU in East-Germany and Sweden: a cross-national factorial validity extension. Scandinavian Journal of Psychology 42, 157160.CrossRefGoogle Scholar
Bender, RE, Alloy, LB (2011). Life stress and kindling in bipolar disorder: review of the evidence and integration with emerging biopsychosocial theories. Clinical Psychology Review 31, 383398.CrossRefGoogle ScholarPubMed
Brown, GH, Harris, TO (1978). Social Origins of Depression: A Study of Psychiatric Disorder in Women. Tavistock Publications: London.Google Scholar
Brown, GH, Harris, TO (1989). Life Events and Illness. Guilford Press: New York.Google ScholarPubMed
Cloninger, C, Przybeck, T, Svrakic, D, Wetzel, R (1994). The Temperament and Character Inventory (TCI): a Guide to its Development and Use. Center for Psychobiology of Personality: St Louis.Google Scholar
Cloninger, CR (1994). Temperament and personality. Current Opinion in Neurobiology 4, 266273.CrossRefGoogle Scholar
Cohen, S, Wills, TA (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin 98, 310357.CrossRefGoogle ScholarPubMed
Compas, BE, Connor-Smith, J, Jaser, SS (2004). Temperament, stress reactivity, and coping: implications for depression in childhood and adolescence. Journal of Clinical Child and Adolescent Psychology 33, 2131.CrossRefGoogle ScholarPubMed
Compas, BE, Connor-Smith, JK, Saltzman, H, Thomsen, AH, Wadsworth, ME (2001). Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychological Bulletin 127, 87127.CrossRefGoogle ScholarPubMed
Craddock, N, Jones, I (1999). Genetics of bipolar disorder. Journal of Medical Genetics 36, 585594.CrossRefGoogle ScholarPubMed
Dienes, KA, Hammen, C, Henry, RM, Cohen, AN, Daley, SE (2006). The stress sensitization hypothesis: understanding the course of bipolar disorder. Journal of Affective Disorders 95, 4349.CrossRefGoogle ScholarPubMed
Dohrenwend, BP (2006). Inventorying stressful life events as risk factors for psychopathology: toward resolution of the problem of intracategory variability. Psychological Bulletin 132, 477495.CrossRefGoogle Scholar
Drancourt, N, Etain, B, Lajnef, M, Henry, C, Raust, A, Cochet, B, Mathieu, F, Gard, S, Mbailara, K, Zanouy, L, Kahn, JP, Cohen, RF, Wajsbrot-Elgrabli, O, Leboyer, M, Scott, J, Bellivier, F (2013). Duration of untreated bipolar disorder: missed opportunities on the long road to optimal treatment. Acta Psychiatrica Scandinavica 127, 136144.CrossRefGoogle Scholar
Duffy, A, Alda, M, Hajek, T, Grof, P (2009). Early course of bipolar disorder in high-risk offspring: prospective study. British Journal of Psychiatry 195, 457458.CrossRefGoogle ScholarPubMed
Duffy, A, Alda, M, Trinneer, A, Demidenko, N, Grof, P, Goodyer, IM (2007). Temperament, life events, and psychopathology among the offspring of bipolar parents. European Child and Adolescent Psychiatry 16, 222228.CrossRefGoogle ScholarPubMed
Duffy, A, Doucette, S, Lewitzka, U, Alda, M, Hajek, T, Grof, P (2011). Findings from bipolar offspring studies: methodology matters. Early Intervention in Psychiatry 5, 181191.CrossRefGoogle Scholar
Duijsens, IJ, Spinhoven, Ph (2001). VTCI. Handleiding van de Nederlandse Verkorte Temperament en Karakter Vragenlijst (VTCI: Manual of the Dutch Short Temperament and Character Questionnaire). Datec: Leiderdorp.Google Scholar
Duijsens, IJ, Spinhoven, Ph, Verschuur, M, Eurelings-Bontekoe, EHM (1999). De ontwikkeling van de Nederlandse verkorte temperament en karakter vragenlijst (TCI-105) (The development of the Dutch shortened temperament and character questionnaire). Nederlands Tijdschrift voor Psychologie 54, 276283.Google Scholar
First, M, Spitzer, R, Gibbon, M, Williams, J (1997). User's Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders – Clinical Version (SCID-CV). American Psychiatric Press: Washington, DC.Google Scholar
Fleming, T, Harrington, D (1991). Counting Processes and Survival Analysis. Wiley: New York.Google ScholarPubMed
Goodwin, F, Jamison, K (2007). Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression. Oxford University Press: New York.Google Scholar
Gottesman, II, Laursen, TM, Bertelsen, A, Mortensen, PB (2010). Severe mental disorders in offspring with 2 psychiatrically ill parents. Archives of General Psychiatry 67, 252257.CrossRefGoogle ScholarPubMed
Grandin, LD, Alloy, LB, Abramson, LY (2007). Childhood stressful life events and bipolar spectrum disorders. Journal of Social and Clinical Psychology 26, 460478.CrossRefGoogle Scholar
Hammen, C (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology 100, 555561.CrossRefGoogle ScholarPubMed
Hammen, C, Gitlin, M (1997). Stress reactivity in bipolar patients and its relation to prior history of disorder. American Journal of Psychiatry 154, 856857.Google Scholar
Hillegers, MH, Burger, H, Wals, M, Reichart, CG, Verhulst, FC, Nolen, WA, Ormel, J (2004). Impact of stressful life events, familial loading and their interaction on the onset of mood disorders: study in a high-risk cohort of adolescent offspring of parents with bipolar disorder. British Journal of Psychiatry 185, 97101.CrossRefGoogle Scholar
Hillegers, MH, Reichart, CG, Wals, M, Verhulst, FC, Ormel, J, Nolen, WA (2005). Five-year prospective outcome of psychopathology in the adolescent offspring of bipolar parents. Bipolar Disorders 7, 344350.CrossRefGoogle ScholarPubMed
Hlastala, SA, Frank, E, Kowalski, J, Sherrill, JT, Tu, XM, Anderson, B, Kupfer, DJ (2000). Stressful life events, bipolar disorder, and the “kindling model”. Journal of Abnormal Psychology 109, 777786.CrossRefGoogle ScholarPubMed
Johnson, SL (2005). Life events in bipolar disorder: towards more specific models. Clinical Psychology Review 25, 10081027.CrossRefGoogle ScholarPubMed
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, Williamson, D, Ryan, N (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry 36, 980988.CrossRefGoogle ScholarPubMed
Kessing, LV, Agerbo, E, Mortensen, PB (2004). Major stressful life events and other risk factors for first admission with mania. Bipolar Disorders 6, 122129.CrossRefGoogle ScholarPubMed
Kessler, RC (1997). The effects of stressful life events on depression. Annual Review of Psychology 48, 191214.CrossRefGoogle ScholarPubMed
Koenders, MA, Giltay, EJ, Spijker, AT, Hoencamp, E, Spinhoven, P, Elzinga, BM (2014). Stressful life events in bipolar I and II disorder: cause or consequence of mood symptoms? Journal of Affective Disorders 161, 5564.CrossRefGoogle ScholarPubMed
Lapalme, M, Hodgins, S, LaRoche, C (1997). Children of parents with bipolar disorder: a metaanalysis of risk for mental disorders. Canadian Journal of Psychiatry 42, 623631.CrossRefGoogle ScholarPubMed
Malkoff-Schwartz, S, Frank, E, Anderson, B, Sherrill, JT, Siegel, L, Patterson, D, Kupfer, DJ (1998). Stressful life events and social rhythm disruption in the onset of manic and depressive bipolar episodes: a preliminary investigation. Archives of General Psychiatry 55, 702707.CrossRefGoogle ScholarPubMed
Mesman, E, Nolen, WA, Reichart, CG, Wals, M, Hillegers, MH (2013). The Dutch Bipolar Offspring Study: 12-year follow-up. American Journal of Psychiatry 170, 542549.CrossRefGoogle ScholarPubMed
Monck, E, Dobbs, R (1985). Measuring life events in an adolescent population: methodological issues and related findings. Psychological Medicine 15, 841850.CrossRefGoogle Scholar
Monroe, SM, Harkness, KL (2005). Life stress, the “kindling” hypothesis, and the recurrence of depression: considerations from a life stress perspective. Psychological Review 112, 417445.CrossRefGoogle ScholarPubMed
Ormel, J, Oldehinkel, AJ, Brilman, EI (2001). The interplay and etiological continuity of neuroticism, difficulties, and life events in the etiology of major and subsyndromal, first and recurrent depressive episodes in later life. American Journal of Psychiatry 158, 885891.CrossRefGoogle ScholarPubMed
Ostiguy, CS, Ellenbogen, MA, Linnen, AM, Walker, EF, Hammen, C, Hodgins, S (2009). Chronic stress and stressful life events in the offspring of parents with bipolar disorder. Journal of Affective Disorders 114, 7484.CrossRefGoogle ScholarPubMed
Perris, C, Jacobsson, L, Lindstrom, H, von Knorring, L, Perris, H (1980). Development of a new inventory assessing memories of parental rearing behaviour. Acta Psychiatrica Scandinavica 61, 265274.CrossRefGoogle ScholarPubMed
Petti, T, Reich, W, Todd, RD, Joshi, P, Galvin, M, Reich, T, Raymond, DJ, Nurnberger, J (2004). Psychosocial variables in children and teens of extended families identified through bipolar affective disorder probands. Bipolar Disorders 6, 106114.CrossRefGoogle ScholarPubMed
Post, RM (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry 149, 9991010.Google ScholarPubMed
R Development Core Team (2008). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria.Google ScholarPubMed
Reichart, CG, Wals, M, Hillegers, MH, Ormel, J, Nolen, WA, Verhulst, FC (2004). Psychopathology in the adolescent offspring of bipolar parents. Journal of Affective Disorders 78, 6771.CrossRefGoogle ScholarPubMed
Reilly-Harrington, NA, Alloy, LB, Fresco, DM, Whitehouse, WG (1999). Cognitive styles and life events interact to predict bipolar and unipolar symptomatology. Journal of Abnormal Psychology 108, 567578.CrossRefGoogle ScholarPubMed
Scheurs, P, van de Willege, G, Tellegen, B, Brosschot, J (1993). Herziene handleiding Utrechtse Coping Lijst (UCL) (Revised manual Utrecht Coping List). Swets & Zeitlinger B.V.: Lisse.Google Scholar
Suppes, T, Leverich, GS, Keck, PE, Nolen, WA, Denicoff, KD, Altshuler, LL, McElroy, SL, Rush, AJ, Kupka, R, Frye, MA, Bickel, M, Post, RM (2001). The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. Journal of Affective Disorders 67, 4559.CrossRefGoogle ScholarPubMed
Swendsen, J, Hammen, C, Heller, T, Gitlin, M (1995). Correlates of stress reactivity in patients with bipolar disorder. American Journal of Psychiatry 152, 795797.Google Scholar
Therneau, TM, Grambsch, PM (2000). Modeling Survival Data: Extending the Cox Model. Springer-Verlag: New York.CrossRefGoogle Scholar
Wainwright, NW, Surtees, PG (2002). Time-varying exposure and the impact of stressful life events on onset of affective disorder. Statistics in Medicine 21, 20772091.CrossRefGoogle ScholarPubMed
Wals, M, Hillegers, MH, Reichart, CG, Ormel, J, Nolen, WA, Verhulst, FC (2001). Prevalence of psychopathology in children of a bipolar parent. Journal of the American Academy of Child and Adolescent Psychiatry 40, 10941102.CrossRefGoogle ScholarPubMed
Wals, M, Hillegers, MH, Reichart, CG, Verhulst, FC, Nolen, WA, Ormel, J (2005). Stressful life events and onset of mood disorders in children of bipolar parents during 14-month follow-up. Journal of Affective Disorders 87, 253263.CrossRefGoogle ScholarPubMed
Zimmermann, P, Bruckl, T, Lieb, R, Nocon, A, Ising, M, Beesdo, K, Wittchen, HU (2008). The interplay of familial depression liability and adverse events in predicting the first onset of depression during a 10-year follow-up. Biological Psychiatry 63, 406414.CrossRefGoogle ScholarPubMed
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