Stress and Manic–Depressive Disorder
The possible association of stressful life events and the onset of depression has generated substantial interest among researchers from various theoretical backgrounds. Most of the literature re-garding analysis of the relationship between stressful life events and manic–depressive disorder has focused on the precipitation of episodes in established manic–depressive disorder rather than the onset of the disorder de novo. There are several studies that dem-onstrate a relationship between stressful life events and the onset of affective episodes in already established manic–depressive disorder. However, several studies failed to find meaningful as-sociations. It is likely that adverse life events are associated with mood episodes, particularly those episodes that are sufficiently severe to warrant hospitalization. In this respect such life events need to be attended to for clinical purposes. However, from a theoretical point of view it is not clear that such events actually play a pathogenic role.