What patients with bipolar disorder and major depressive disorder perceive as adverse life events precipitating a current major depressive episode

Adverse life events (ALEs) as precipitants of a major depressive episode (MDE) have been the subject of many studies.[1-7] Such studies indicate that there tends to be an increase in ALEs in the 6 months preceding an MDE.[1,4,5] In line with the ‘kindling effect’ hypothesis more stressful ALEs are needed for the first MDE, with progressively less stressful ALEs needed for subsequent episodes.[8] The kindling effect hypothesis holds that major life stressors are required to trigger the initial onset of a mood episode, but that subsequent episodes become progressively less tied to stressors, so that they eventually occur spontaneously, or at least seemingly spontaneously.[8-10] Since this original idea was postulated by Post[8] several studies have supported the hypothesis[6,7,11-13] while others have not.[14-16] Apart from a study examining the differences in ALEs between patients with dysthymic disorder and major depressive disorder (MDD)[17] to the best of the authors’ knowledge, no study has yet compared the severity of ALEs before an MDE in relation to bipolar disorder (BD) and MDD. This study aims to make that comparison. The study examines participants who suffer from MDD or BD who recently suffered a first MDE or a recurrence of an MDE, specifically regarding what these participants perceive as the precipitating ALE of their current MDE. The study also compares the severity and categories of ALEs between participants suffering from MDD and BD.