title: The Relationship Between Stressful Life Events and Axis I Diagnoses Among Adolescent Offspring of Probands With Bipolar and Non-Bipolar Psychiatric Disorders and Healthy Controls: The Pittsburgh Bipolar Offspring Study (BIOS).
abstract: BACKGROUND
  Previous studies have explored the role of stressful life events in the development of mood disorders. We examined the frequency and nature of stressful life events as measured by the Stressful Life Events Schedule (SLES) among 3 groups of adolescent offspring of probands with bipolar (BD), with non-BD psychiatric disorders, and healthy controls. Furthermore, we examined the relationship between stressful life events and the presence of DSM-IV Axis I disorders in these offspring. Stressful life events were characterized as dependent, independent, or uncertain (neither dependent nor independent) and positive, negative, or neutral (neither positive nor negative).
  
  
  METHODS
  Offspring of probands with BD aged 13-18 years (n = 269), demographically matched offspring of probands with non-BD Axis I disorders (n = 88), and offspring of healthy controls (n = 81) from the Pittsburgh Bipolar Offspring Study were assessed from 2002 to 2007 with standardized instruments at intake. Probands completed the SLES for their offspring for life events within the prior year. Life events were evaluated with regard to current Axis I diagnoses in offspring after adjusting for confounds.
  
  
  RESULTS
  After adjusting for demographic and clinical between-group differences (in probands and offspring), offspring of probands with BD had greater independent (χ² = 11.96, P < .04) and neutral (χ² = 17.99, P < .003) life events compared with offspring of healthy controls and greater number of more severe stressful life events than offspring of healthy controls, but not offspring of probands with non-BD. Offspring of BD probands with comorbid substance use disorder reported more independent stressful life events compared to those without comorbid substance use disorder (P = .024). Greater frequency and severity of stressful life events were associated with current Axis I disorder in offspring of both probands with BD and probands with other Axis I disorders regardless of dependency or valence. Greater frequency and severity of stressful life events were associated with greater current Axis I disorder in all offspring.
  
  
  CONCLUSIONS
  Offspring of probands with BD have greater exposure to independent and neutral life events than offspring of healthy controls. Greater frequency and severity of stressful life events were associated with Axis I disorder in offspring of both BD and non-BD affected probands.
authors.affiliation: 100 N Bellefield Ave, Rm 320, Pittsburgh, PA 15213. thomasla@upmc.edu.|Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Pan
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Tina R
authors.initials: TR
authors.lastname: Goldstein
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Rooks
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Hickey
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Jie Yu
authors.initials: JY
authors.lastname: Fan
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: John
authors.initials: J
authors.lastname: Merranko
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Monk
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Rasim S
authors.initials: RS
authors.lastname: Diler
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Dara J
authors.initials: DJ
authors.lastname: Sakolsky
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Danella
authors.initials: D
authors.lastname: Hafeman
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Goldstein
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
authors.affiliation: Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, Ohio, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Axelson
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology*; D016241:Child of Impaired Parents / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology*; D012016:Reference Values; D012306:Risk; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology