Types of environmental stressors and social support in bipolar disorder

Environmental Stressors (ES) are among the triggering factors of mood fluctuations in Bipolar Disorder (BD). This study explored the types and intensity of ESs causing mood fluctuations and whether perceived support had an influence on that relationship. In this descriptive study, 24 patients, who were diagnosed with BD type I or II within the three years prior to current study were included; and 24 Healthy Controls (HC) were matched in terms of age, sex and educational level. Life Events and Difficulties Schedule (LEDS) was used to screen for numbers, domains, and threat level of life events (stressors < 1 month) and difficulties (stressors > 1 month), as well as positive support, and negative reactions to each stressor. Screening period included one year before the first manic or hypomanic episode. Compared to HC, BD patients reported higher numbers of total life events and difficulties particularly in education, work, medical health, partner and interpersonal relationships domains. Patients were exposed to greater negative reactions from others, especially after the onset of BD. There were no differences between the groups regarding perceived social support from others. Findings highlighted the triggering effect of severe ES on BD onset, types of ES, and perceived social reaction.