Bipolar MANIAS: Life events help confirm the diagnosis
Can knowing a patient’s environmental stressors and family history help us more quickly diagnose bipolar mania?
Kessing et al1 studied patients who were diagnosed as having mania or a mixed episode during their first psychiatric hospitalization. They found that certain life events were associated with these diagnoses, reinforcing the belief that environment to some extent influences psychiatric illness.
Although more research is needed, this finding may help psychiatrists reach a diagnosis of bipolar mania when the clinical course is unclear. Life events that may contribute to bipolar mania are remembered with the mnemonic MANIAS:
- Marital status change. The patient recently was married, divorced, or lost a significant other to death.
- Family Admission. The patient’s mother, father, or sibling was hospitalized at some point for a psychiatric disorder. It does not seem to matter whether the patient remembers the family member’s hospitalization.
- No work. The patient is unemployed.
- Inability to work. The patient is disabled or collects disability benefits.
- Abstaining from relationships. The patient does not have a significant other.
- Suicide was completed by the patient’s mother, father, or sibling. It does not matter how long ago or at what point in the patient’s life the suicide happened.
1. Kessing LV, Agerbo E, Mortensen PB. Major stressful life events and other risk factors for first admission with mania. Bipolar Disord 2004;6(2):122-9.
Dr. Wilson is a fellow, division of child and adolescent psychiatry, department of psychiatry, Louisiana State University Health Sciences Center, New Orleans.