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The British Journal of Psychiatry (2004) 185: 97-101
© 2004 The Royal College of Psychiatrists

Impact of stressful life events, familial loading and their interaction on the onset of mood disorders

Study in a high-risk cohort of adolescent offspring of parents with bipolar disorder

MANON H. J. HILLEGERS, MD

Altrecht, Institute for Mental Health Care, Utrecht

HUIBERT BURGER, PhD

University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht

MARJOLEIN WALS, MS, CATRIEN G. REICHART, MD and FRANK C. VERHULST, PhD

Erasmus Medical Centre Rotterdam/Department of Child and Adolescent Psychiatry, Sophia Children's Hospital, Rotterdam

WILLEM A. NOLEN, PhD

University of Groningen Department of Psychiatry, Groningen, and Altrecht, Institute for Mental Health Care

JOHAN ORMEL, PhD

University of Groningen, Department of Psychiatry & Graduate School Behaviour, Cognitive and Neurosciences, Groningen

Correspondence: M. Hillegers, Altrecht Institute for Mental Health Care, Lange Nieuwstraat 119, 3512 PG Utrecht, The Netherlands. Tel: +31 3023088888; e-mail: m.hillegers{at}altrecht.nl

Declaration of interest Supported by NWO (Dutch Organisation for Scientific Research) and the Stanley Medical Research Institute.

Background Stressfullife events are established as risk factors for the onset of mood disorders, but few studies have investigated their impact on the development of mood disorders in adolescents.

Aims To study the effect of life events on the development of mood disorders in the offspring of parents with bipolar disorder, with respect to the possibility of a decay effect and modification by familial loading.

Method In a high-risk cohort of 140 Dutch adolescent offspring of parents with bipolar disorder, we assessed life events, current and past DSM—IV diagnoses and familial loading. To explore their interaction and impact on mood disorder onset, we constructed four different models and used a multivariate survival analysis with time-dependent covariates.

Results The relationship between life events and mood disorder was described optimally with a model in which the effects of life events gradually decayed by 25% per year. The effect of life event load was not significantly stronger in the case of high familial loading.

Conclusions Independent of familial loading, life events increase the liability to mood disorders in children of patients with bipolar disorder but the effects slowly diminish with time.


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