Objective: To understand the role of social stressors and life events in the recurrence and treatment of bipolar disorder in the elderly.
Design: We will review the current literature on social support and negative life events in patients with bipolar disorder. In addition, we will report on our ongoing study of stressful life events and social support in older bipolar patients, comparing the results with younger bipolar patients and controls. We will also assess the effect of the age of onset of bipolar disorder and the influence of stressful life events and social support .
Materials and Methods: We conducted a cross-sectional survey of over 100 bipolar patients evaluating their exposure to stressful life events during the previous 12 months, and their current level of social support.
Results:Younger, but not older, bipolar subjects experienced more stressful life events than similar aged controls for euthymic, manic, and depressed subjects. Older bipolar patients had limited social support systems compared with older controls.
Conclusion: Impaired social support is present in older bipolar patients at a level higher than older controls. Stressful life events appear to be similar between older bipolar patients and controls, but less than what is seen in younger bipolar patients. The implications of limited social support in elderly still needs to be better identified. In unipolar depressed patients, the impaired social support is associated with worse outcomes. The role of psychoeducation for patients, families and caregivers has not been tested.
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