The role of loss and danger events in symptom exacerbation in bipolar disorder.

Research concerned with the association between stressful life events [SLEs] and bipolar disorder [BD] is inconsistent. Drawing on the unipolar depression literature, specific classifications of events (in particular, humiliation and loss events) seem to be especially important, while for anxiety disorders loss and danger events have been found to be pertinent. However, little or nothing is known about the relationship between such events and BD. The aim of the present investigation is to examine the association between danger and loss events and symptom exacerbation in BD. A total of 96 BD participants were interviewed using the Life Events and Difficulties Schedule [LEDS] at two time points: baseline and 4 month follow-up. Self-report and observer-rated symptom measures were administered at both interviews. The Beck Depression Inventory-Second Edition and the Montgomery Asberg Depression Rating Scale were used to measure depressive symptoms. The Self-Report Mania Inventory and Clinician-Administered Rating Scale for Mania were used to rate manic symptoms. Independent severe events, independent loss events and independent danger events were found to be significantly associated with worsening of depressive symptoms over an 8-month period. No significant associations were observed for manic symptoms. Specific relationships with different types of SLEs may explain previous discrepant findings concerning the relationship between SLEs and BD.