Stressful life events and onset of mood disorders in children of bipolar parents during 14-month follow-up.
BACKGROUND
Although multiple studies have examined the association between stressful life events (SLEs) and the development of mood disorders, the exact nature of the association and the degree to which it is independent from familial loading (FL) and gender-specific are still not fully elucidated.


OBJECTIVE
To study the association between person-independent and -dependent SLEs and first onset or recurrence of a DSM-IV mood disorder episode (MDE) in offspring of bipolar parents. To examine interaction effects of SLEs with familial loading and gender.


METHODS
Offspring of bipolar parents (N=132) were assessed with the K-LEDS, the FHRDC and the K-SADS. Logistic regression analysis was used to examine main and interaction effects of various operationalizations of SLEs, familial loading and gender.


RESULTS
Dependent SLEs were more likely to occur before onset among the 13 offspring who had a MDE onset during the 14-month follow-up (39%) than in a comparable period among the 67 controls without any lifetime diagnosis (10%). Associations were slightly stronger for first onsets than for recurrences. The association between SLEs and MDE onset/recurrence was independent of socio-demographic characteristics and familial loading, but disappeared when adjusted for baseline anxious/depressive symptoms. Gender and familial loading did not modify the influence of any SLE measure on the development of mood disorders.


CONCLUSIONS
In this sample of bipolar offspring dependent stressful SLEs triggered the onset of MDEs, but this association disappeared after adjustment of prior anxious/depressive symptoms, indicating that the association between SLEs and MDE is probably a spurious association. No interaction was found between SLE and FL and gender. Prior anxious/depressive symptoms seem to increase the risk for both occurrence of dependent SLEs and MDE onset or recurrence.


CONCLUSIONS
Limited statistical power due to small number of MDE onsets.
Erasmus Medical Center Rotterdam/Department of Child and Adolescent Psychiatry, Sophia Children's Hospital, Rotterdam, The Netherlands. m.wals@erasmusmc.nl
Marjolein
M
Wals
Manon H J
MH
Hillegers
Catrien G
CG
Reichart
Frank C
FC
Verhulst
Willem A
WA
Nolen
Johan
J
Ormel
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data*; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D008403:Mass Screening; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology*; D010290:Parents / Q000523:psychology*; D012008:Recurrence; D011795:Surveys and Questionnaires