title: The influence of life events on first and recurrent admissions in bipolar disorder.
abstract: BACKGROUND
  Life events play an important role in the onset and course of bipolar disorder. We will test the influence of life events on first and recurrent admissions in bipolar disorder and their interaction to test the kindling hypothesis.
  
  
  METHODS
  We collected information about life events and admissions across the life span in 51 bipolar patients. We constructed four models to explore the decay of life event effects on admissions. To test their interaction, we used the Andersen-Gill model.
  
  
  RESULTS
  The relationship between life events and admissions was best described with a model in which the effects of life events gradually decayed by 25% per year. Both life event load and recurrent admissions significantly increased the risk of both first and subsequent admissions. No significant interaction between life event load and number of admissions was found.
  
  
  CONCLUSIONS
  Life events increase the risk of both first and recurrent admissions in bipolar disorder. We found no significant interaction between life events and admissions, but the effect of life events on admissions decreases after the first admission which is in line with the kindling hypothesis.
authors.affiliation: Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, A00.241, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Sanne M
authors.initials: SM
authors.lastname: Kemner
authors.affiliation: Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, A00.241, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Neeltje Em
authors.initials: NE
authors.lastname: van Haren
authors.affiliation: Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, A00.241, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Florian
authors.initials: F
authors.lastname: Bootsman
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Marinus Jc
authors.initials: MJ
authors.lastname: Eijkemans
authors.affiliation: Reinier van Arkel Group, 's-Hertogenbosch, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Vonk
authors.affiliation: Alzheimer Nederland, Amersfoort, The Netherlands.
authors.forename: Astrid C
authors.initials: AC
authors.lastname: van der Schot
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.affiliation: Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, A00.241, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Manon Hj
authors.initials: MH
authors.lastname: Hillegers
keywords: Admissions; Bipolar disorder; Life events; Mood disorder; Twins