STRESSFUL LIFE EVENTS AND SOCIAL RHYTHM DISRUPTION IN THE ONSET OF MANIC AND DEPRESSIVE BIPOLAR EPISODES - A PRELIMINARY INVESTIGATION

Background: The association between stressful life events and onset of bipolar episodes is unclear. The association between bipolar episode onset and types of life events that disrupt social routines, and poten tially sleep, has not yet been investigated. Methods: Thirty-nine bipo lar patients with primarily manic (n = 20) or depressed in = 19) index episodes were inter viewed with the Bedford College Life Event and Di fficulty Schedule to determine the presence severe events during 8-wee k pre-onset and control periods. All-life events were also rated for d egree of social rhythm disruption (SRD). Results: More bipolar subject s experienced at least 1 SRD event and severe event in the pre-onset v s control periods. When subjects were divided into those mich manic or depressive onsets, the only significant pre-onset vs control differen ce was for manic patients with SRD events. Additionally, the proportio n of subjects with a preonset SRD event was greater for manic than for depressed patients. Conclusions: We found evidence that life events c haracterized by SRD5 routines are associated with the onset of manic, but not depressive, episodes. Severe events seem to be related to onse t of bipolar episodes. although it remains unclear wheteher severe eve nts relate differentially to depressive and manic onsets.