Department of Psychology, Bar Ilan University, Ramat Gan 52900, Israel.
Compr Psychiatry. 2010 Mar-Apr;51(2):157-64. doi: 10.1016/j.comppsych.2009.05.005. Epub 2009 Jul 10.
The present study aimed to explore the association between stressful life events (LEs) and the development of affective psychopathology.
Thirty patients with unipolar disorder and 30 patients with bipolar disorder were compared to 60 matched healthy controls in regard to the rate of stressful LEs. Assessment measures included the Beck Depression Inventory, the Adult Life Events Questionnaire, and the Childhood Life Events List.
The entire sample of affective patients had more LEs in general, more negative LEs, and more loss-related LEs in the year preceding their first depressive episode as compared with normal controls. Subjects with unipolar disorder had more positive LEs and more achievement LEs, whereas subjects with bipolar disorder had more uncontrollable LEs in the year preceding the first depressive episode. The relationship between LEs and manic episodes was prominent in the year preceding the first manic episode, with subjects with bipolar disorder reporting more LEs in general and more ambiguous events in that year. Almost no significant differences on LE frequency were observed in the year before the last depressive and manic episodes in the patient groups with unipolar and bipolar disorder. A significant relationship was found between childhood LEs and the development of affective disorders in adulthood, with patients with unipolar disorder exhibiting less positive and achievement LEs.
In both the unipolar and the bipolar groups, the major impact of LEs on the onset of affective disorders was found in the year before the first depressive or manic episodes. This suggests that the accumulation of stressful LEs at this crucial period contributes to the precipitation of a pathological response mechanism. Once established, this mechanism would be reactivated in the future by even less numerous and less severe stressors, compatible with the kindling hypothesis.
本研究旨在探讨生活应激事件（LEs）与情感精神病理学发展之间的关系。
将 30 例单相障碍患者和 30 例双相障碍患者与 60 例匹配的健康对照者进行比较，评估其生活应激事件的发生率。评估措施包括贝克抑郁量表、成人生活事件问卷和儿童生活事件清单。
与正常对照组相比，所有情感障碍患者在首次抑郁发作前一年总的生活应激事件更多、负性生活应激事件更多、与丧失相关的生活应激事件更多。单相障碍患者正性生活应激事件更多、成就性生活应激事件更多，而双相障碍患者首次抑郁发作前一年无法控制的生活应激事件更多。双相障碍患者首次躁狂发作前一年的生活应激事件与躁狂发作之间的关系更为显著，双相障碍患者报告的生活应激事件更多，且更为模糊。单相和双相障碍患者在抑郁和躁狂发作前一年的生活应激事件频率几乎没有显著差异。在成年后出现情感障碍的儿童生活应激事件与生活应激事件之间存在显著关系，单相障碍患者的正性和成就性生活应激事件较少。
在单相和双相障碍组中，生活应激事件对情感障碍发作的主要影响发生在首次抑郁或躁狂发作前一年。这表明，在这一关键时期应激事件的积累导致病理性反应机制的发生。一旦建立，该机制在未来即使遇到更少的、更轻微的应激源也会被再次激活，这与点燃假说一致。
