Citation

Aldinger F, Schulze TG. Psychiatry Clin. Neurosci. 2016; 71(1): 6-17.

Affiliation

Institute of Psychiatric Phenomics and Genomics (IPPG), Ludwig-Maximilians-University, Munich.

Copyright

(Copyright © 2016, John Wiley and Sons)

DOI

10.1111/pcn.12433

PMID

27500795

Abstract

OBJECTIVE: The etiology and clinical course of bipolar disorder are considered to be determined by genetic and environmental factors. Although the kindling hypothesis emphasizes the impact of environmental factors on initial onset, their connection to the outcome and clinical course has been poorly established. Hence, there have been numerous research efforts to investigate the impact of environmental factors on the clinical course of illness. Our aim is to outline recent research on the impact of environmental determinants on the clinical course of bipolar disorder.

METHODS: We carried out a computer-aided search to find publications on an association between environmental factors, life events and the clinical course of bipolar disorder. Publications in the reference lists of suitable papers have been taken into consideration as well. We performed a narrative overview on all eligible publications.

RESULTS: The available body of data supports an association between environmental factors and the clinical course of bipolar disorder. These factors comprise prenatal, early-life, and entire life span aspects.

CONCLUSION: Given varying sample sizes and several methodological limitations, the reported quality and extent of the association between environmental factors and the clinical course of bipolar disorder should be interpreted with utmost caution. Systematic longitudinal long term follow-up trials are needed to obtain a clearer and more robust picture.

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Language: en