Badania nad rolą wydarzeń życiowych w zaburzeniu afektywnym dwubiegunowym
Psychiatr Pol 2013;47(5):875-885
This review focuses on latest research regarding the role of life events in bipolar disorder. Description of important patients experiences and mechanisms, according to which they operate, is the key issue in diagnostics, therapy, prevention and planning of further studies. Definitions of life events differ depending on theoretical conceptions. At the same time they can be divided on the basis of time relation between the occurrence of event and disorder. Events that can play important role in bipolar disorders are the following: early childhood traumas, early loss of important family member and current stressful events. Taking the latter into account, positive experiences connected with performances can affect manic symptoms, and negative events - depressive ones. The other group of important life events in this context consists of life events that are dependent on the patients' psychopathology. Hypotheses of kindling, manic denial or stress-diathesis model can explain mechanisms of these relations. The role of life events is probably modified by personality, temperament and coping mechanisms. Congruency of life events with personality styles is being underlined. There is a substantial lack of research in this field. Their integration with knowledge of genetic vulnerability and connection with neurobiological base with life events' reactions (e.g. catechol-omethyl transferase, BDNFVal(66)Met genotype) is needed. Further research require consideration of methodological issues, like research plans and models (that will make integration of knowledge from different studies fields possible) or specific diagnostic methods.
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