Stressful life events, bipolar disorder, and the "kindling model"

A common misconception is that bipolar disorder is an endogenous process. H owever, previous research suggests a role for life events in the onset of a nd recovery from bipolar episodes. Yet, there remains some question as to w hether the relationship between life events and onset changes over the cour se of the disorder as a result of the number of episodes an individual has experienced. Using a rigorous interview measure of stressful life events, t he current study tested the kindling model (R. M. Post, 1992), which theori zes that major life events play a diminishing role over me course of illnes s in bipolar patients. Analyses revealed that the number of episodes experi enced does not appear to have a significant effect on bipolar 1 patients' r eactivity to external stressors. In addition, the results suggest that a mo re complex relationship exists among age, stress, and onset of new episodes than can be adequately explained by the kindling model.