Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India.
Psychiatry Res. 2017 Dec;258:434-437. doi: 10.1016/j.psychres.2017.08.073. Epub 2017 Aug 30.
Stressful life events can precipitate relapses and recurrences in bipolar disorder. Kindling in bipolar disorder has been linked to maladaptive psychological reactivity to minor stressful life events. Systematic studies on life events and kindling are rare in bipolar disorder with a manic predominant polarity. One hundred and forty-nine remitted patients with bipolar I disorder were recruited. The National Institute of Mental Health-Life Chart Methodology was used to depict the illness course retrospectively, and the Presumptive Stressful Life Events Scale-Lifetime version was used to record the stressful life events. The role of stressful life events and the probability of kindling were assessed using appropriate statistics. There was a mania-predominant course of bipolar disorder in the sample with 55.7% (n = 83) having only recurrent mania. Family conflict and altered sleep patterns were the commonly reported stressful life events. When controlled for the severity of the stressor, the stressful life events were often associated with the initial episodes rather than the latter ones. Kindling may occur in bipolar disorder with mania as the predominant polarity. However, retrospective recall bias and hospital-based sampling limit generalizability of such observations.
生活应激事件可促发双相障碍复发和再发。双相障碍的点燃现象与对轻微生活应激事件的适应不良的心理反应有关。在以躁狂为主的双相障碍中，对生活事件和点燃现象进行系统研究较为少见。本研究共纳入 149 例缓解期单相 I 型双相障碍患者。采用美国国立精神卫生研究所生活图表法回顾性描述疾病过程，采用生活事件预期量表-终生版记录生活应激事件。采用适当的统计学方法评估生活应激事件的作用和点燃的可能性。该样本中存在以躁狂为主的双相障碍病程，仅有复发性躁狂的患者占 55.7%（n=83）。家庭冲突和睡眠模式改变是常见的生活应激事件。在控制应激源严重程度后，生活应激事件通常与首发发作而不是后续发作有关。点燃现象可能发生在以躁狂为主的双相障碍中。然而，回顾性回忆偏倚和基于医院的抽样限制了此类观察结果的普遍性。
