Specific episode triggers in young adults with BD identified

Aug 16 2012

By Mark Cowen, Senior MedWire Reporter

Falling in love has the highest specificity for triggering manic/hypomanic episodes in young adults with bipolar disorder (BD), while stressful life events has the highest specificity for triggering depressive episodes, researchers report.

Judith Proudfoot (University of New South Wales and Black Dog Institute, Randwick, Australia) and team also found that routine change was the most common trigger for both manic/hypomanic and depressive episodes among young adults with the mood disorder.

"While it may not be feasible to avoid some triggers, such as falling in love or stressful life events, identification of a link between these events and the onset of mood episodes may indicate to an individual that more diligent monitoring of mood and prophylactic strategies may be needed during such times," comment the researchers in the Journal of Affective Disorders.

The findings come from a study of 198 individuals with BD who were aged between 18 and 30 years.

All of the participants completed questionnaires in which they were asked to identify triggers unique to manic/hypomanic or depressive episodes, as well as triggers common to both types of mood episode.

The participants scored each trigger on a scale from 0 (not a trigger) to 4 (nearly always a trigger).

The researchers found that for manic/hypomanic episodes, the trigger with the highest specificity was falling in love, at a mean score of 2.8, followed by recreational stimulant use (2.5), and starting a creative project (2.4). Other triggers with high specificity for manic/hypomanic episodes included partying all night, going on vacation, and periods of personal growth.

For depressive episodes, the trigger with the highest specificity was stressful life events, at a score of 3.3, followed by general stress (3.1), and fatigue (2.9). Other triggers associated with depressive episodes included sleep deprivation, physical injury/illness, and menstruation.

Triggers associated with both manic/hypomanic and depressive episodes included routine change, chaotic situations, alcohol consumption, and diet change.

Proudfoot et al conclude: "The current research extends the existing literature by identifying triggers most prominent in young adults with BD."

They add: "Identification of a unique set of triggers for mania/hypomania and a unique set for depression in young adults with BD may allow for earlier identification of episodes, thus increasing opportunities for early intervention."

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