The authors examined the impact of life stress on the course of bipolar
disorder over a 2-year period in a group of 61 outpatients. The patients
were followed prospectively with ongoing assessments of stressful life
events, symptoms, levels of maintenance medication, and compliance with
treatment regimens. As predicted, survival analyses indicated a significant
association between life events and relapse or recurrence of the disorder.
These effects could not be explained by differences in levels of medication
or compliance. Further research is recommended to examine which specific
subgroups of bipolar patients are most susceptible to stress.