Major stressful life events and other risk factors for first admission with mania
Major stressful life events and other risk factors for first admission with mania
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DOI：
10.1111/j.1399-5618.2004.00102.x
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发表时间：
2004-04-01
影响因子：
5.4
通讯作者：
Mortensen, PB
中科院分区：
文献类型：
--
作者：
Kessing, LV;Agerbo, E;Mortensen, PB
目的：调查首次因躁狂入院是否与家庭死亡或重大压力生活事件有关，并探讨这种关联是否随年龄而变化。方法：病例登记研究与丹麦精神病学中央研究登记册的联系，包括 1981 年至 1998 年丹麦精神病房所有入院的数据，以及民事登记系统，包括死亡和社会人口变量的数据。确定了首次入院时被诊断为躁狂/混合发作的所有患者以及从未入住过精神病房的随机性别和年龄匹配的对照组受试者。 结果：总共确定了 1565 名患者和 31 300 名对照受试者。母亲或兄弟姐妹的自杀与首次被诊断为躁狂/混合发作而入住精神科病房的风险大大增加有关。亲属因自杀以外的其他原因死亡与因躁狂症住院的风险增加无关。最近的失业、最近的离婚以及最近的婚姻都显示出适度的影响。没有发现生活事件与首次入院躁狂症之间存在交互作用，无论是男性还是女性，单独与衰老相关。结论：家庭中死亡的发生和重大生活事件的经历与首次入院双相情感障碍的风险增加有关。对诱发躁狂的主要生活压力源的敏感性似乎在一生中都没有改变。
Objectives: To investigate whether first admission with mania is associated with the occurrence of death in the family or with major stressful life events and to explore whether the associations change with age.Methods: Case register study with linkage of the Danish Psychiatric Central Research Register, including data on all admissions at psychiatric wards in Denmark from 1981 to 1998, and the Civil Registration System, including data on death and on socio-demographic variables. All patients who got a diagnosis of mania/mixed episode at the first ever admission at a psychiatric ward and a random gender- and age-matched control group of subjects who had never been admitted to psychiatric ward were identified.Results: A total of 1565 patients and 31 300 control subjects were identified. Suicide of a mother or of a sibling was associated with a highly increased risk of being admitted for the first time ever at a psychiatric ward with a diagnosis of mania/mixed episode. Death of a relative by other causes than suicide was not associated with increased risk of getting hospitalized with mania. Recent unemployment, recent divorce, but also a recent marriage showed moderate effects. No interaction was found on the association between life events and the first admission with mania, totally, or for men or women, separately regarding ageing.Conclusions: The occurrence of death in the family and the experience of major life events are associated with increased risk of first admission with bipolar disorder. The susceptibility to major life stressors of inducing mania does not seem to change throughout life.