Author:
POST ROBERT M.,LEVERICH GABRIELE S.,XING GUOQIANG,WEISS SUSAN R. B.
Abstract
Different types of psychosocial stressors have long been recognized as potential precipitants
of both unipolar and bipolar affective episodes and the causative agents in posttraumatic stress
disorder (PTSD). New preclinical data have revealed some of the neurobiological mechanisms
that could convey the long-term behavioral and biochemical consequences of early stressors.
Depending on the timing, quality, quantity, and degree of repetition, maternal deprivation stress in
the neonatal rodent can be associated with lifelong anxiety-like behaviors, increases in stress
hormones and peptides, and proneness to drug and alcohol administration, in association with
acute changes in the rate of neurogenesis and apoptosis (preprogrammed cell death) and
decrements in neurotrophic factors and signal transduction enzymes necessary for learning and
memory. Patients with bipolar illness who have a history of early extreme adversity (physical or
sexual abuse in childhood or adolescence), compared with those without, show an earlier onset of
illness, faster cycling frequencies, increased suicidality, more Axis I and Axis II comorbidities
(including alcohol and substance abuse), and more time ill in more than 2 years of prospective
follow-up. These findings are subject to a variety of interpretations, but to the extent that the
more severe course of bipolar illness characteristics are directly and causally related to these early
stressful experiences, early recognition and treatment of high-risk children could be crucial in
helping to prevent or ameliorate the long-term adverse consequences of these stressors.
Publisher
Cambridge University Press (CUP)
Subject
Psychiatry and Mental health,Developmental and Educational Psychology
Cited by
116 articles.
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