BACKGROUND: Studies of adult bipolar patients and adolescents with major depression indicate that life stress and mood symptoms are temporally and causally related to one another. This study examined whether levels of life stress predict levels of mood symptoms among bipolar adolescents participating in a treatment development study of family-focusedpsychoeducation and pharmacotherapy. METHODS:Bipolar adolescents (n=38) who reported a period of acute mood symptoms within the prior 3 months were recruited for a 1-year study of life stress. Clinician-administered evaluations were completed with adolescents and parents at 3-month intervals for up to 12 months, using the UCLA Life Stress Interview and the K-SADS Mania and Depression Rating Scales. RESULTS:Chronic stress in family, romantic and peer relationships was associated with less improvement in mood symptoms over the study year. The frequency of severe, independent life events also predicted less improvement in mood symptoms. Higher levels of chronic stress in family and romantic relationships, and higher severity of independent events, were more strongly associated with mood symptoms among older adolescents. Results were independent of adolescents' psychosocial treatment regimens. LIMITATIONS: The majority of adolescents received family-focused psychoeducational treatment and all were being treated with psychotropic medication. The influence of life stress on mood symptoms may have been attenuated by intensive intervention. CONCLUSIONS: Stress is linked to changes in mood symptoms among bipolar adolescents, although correlations between life events and symptoms vary with age. Chronic stress in family, romantic, and peer relationships are important targets for psychosocial intervention.
RCT Entities:
BACKGROUND: Studies of adult bipolarpatients and adolescents with major depression indicate that life stress and mood symptoms are temporally and causally related to one another. This study examined whether levels of life stress predict levels of mood symptoms among bipolar adolescents participating in a treatment development study of family-focused psychoeducation and pharmacotherapy. METHODS:Bipolar adolescents (n=38) who reported a period of acute mood symptoms within the prior 3 months were recruited for a 1-year study of life stress. Clinician-administered evaluations were completed with adolescents and parents at 3-month intervals for up to 12 months, using the UCLA Life Stress Interview and the K-SADS Mania and Depression Rating Scales. RESULTS: Chronic stress in family, romantic and peer relationships was associated with less improvement in mood symptoms over the study year. The frequency of severe, independent life events also predicted less improvement in mood symptoms. Higher levels of chronic stress in family and romantic relationships, and higher severity of independent events, were more strongly associated with mood symptoms among older adolescents. Results were independent of adolescents' psychosocial treatment regimens. LIMITATIONS: The majority of adolescents received family-focused psychoeducational treatment and all were being treated with psychotropic medication. The influence of life stress on mood symptoms may have been attenuated by intensive intervention. CONCLUSIONS: Stress is linked to changes in mood symptoms among bipolar adolescents, although correlations between life events and symptoms vary with age. Chronic stress in family, romantic, and peer relationships are important targets for psychosocial intervention.
Authors: Barbara Geller; James L Craney; Kristine Bolhofner; Michael J Nickelsburg; Marlene Williams; Betsy Zimerman Journal: Am J Psychiatry Date: 2002-06 Impact factor: 18.112
Authors: B Geller; K Bolhofner; J L Craney; M Williams; M P DelBello; K Gundersen Journal: J Am Acad Child Adolesc Psychiatry Date: 2000-12 Impact factor: 8.829
Authors: Rebecca S Siegel; Bettina Hoeppner; Shirley Yen; Robert L Stout; Lauren M Weinstock; Heather M Hower; Boris Birmaher; Tina R Goldstein; Benjamin I Goldstein; Jeffrey I Hunt; Michael Strober; David A Axelson; Mary Kay Gill; Martin B Keller Journal: J Nerv Ment Dis Date: 2015-03 Impact factor: 2.254
Authors: Matthew E Young; Thania Galvan; Brooke L Reidy; Matthew F Pescosolido; Kerri L Kim; Karen Seymour; Daniel P Dickstein Journal: J Affect Disord Date: 2013-05-22 Impact factor: 4.839
Authors: Heather A MacPherson; Amanda L Ruggieri; Rachel E Christensen; Elana Schettini; Kerri L Kim; Sarah A Thomas; Daniel P Dickstein Journal: J Affect Disord Date: 2018-04-16 Impact factor: 4.839
Authors: David J Miklowitz; Mary P O'Brien; Danielle A Schlosser; Jean Addington; Kristin A Candan; Catherine Marshall; Isabel Domingues; Barbara C Walsh; Jamie L Zinberg; Sandra D De Silva; Michelle Friedman-Yakoobian; Tyrone D Cannon Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-06-02 Impact factor: 8.829
Authors: Amit Shalev; John Merranko; Tina Goldstein; David J Miklowitz; David Axelson; Benjamin I Goldstein; David Brent; Kelly Monk; Mary Beth Hickey; Danella M Hafeman; Dara Sakolsky; Rasim Diler; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2018-12-19 Impact factor: 8.829
Authors: Soledad Romero; Boris Birmaher; David A Axelson; Ana-Maria Iosif; Douglas E Williamson; Mary Kay Gill; Benjamin I Goldstein; Michael A Strober; Jeffrey Hunt; Tina R Goldstein; Christianne Esposito-Smythers; Satish Iyengar; Neal D Ryan; Martin Keller Journal: J Clin Psychiatry Date: 2009-10 Impact factor: 4.384
Authors: Maria Andreu Pascual; Jessica C Levenson; John Merranko; Mary Kay Gill; Heather Hower; Shirley Yen; Michael Strober; Tina R Goldstein; Benjamin I Goldstein; Neal D Ryan; Lauren M Weinstock; Martin B Keller; David Axelson; Boris Birmaher Journal: J Affect Disord Date: 2020-05-22 Impact factor: 4.839
Authors: Casey L McGrath; Stephen J Glatt; Pamela Sklar; Helen Le-Niculescu; Ronald Kuczenski; Alysa E Doyle; Joseph Biederman; Eric Mick; Stephen V Faraone; Alexander B Niculescu; Ming T Tsuang Journal: BMC Psychiatry Date: 2009-11-12 Impact factor: 3.630