Life events and relapse in bipolar disorder: the impact of a catastrophic event

The literature on life events and the precipitation of bipolar disorder is reviewed. The authors describe an unexpected increase in bipolar relapses in a Lithium Clinic following a catastrophic life event, a hurricane, and contrast the patients who relapsed with an age and sex matched control of bipolars who did not. Though retrospective, the study avoids the question of the independence of life events. The results suggest that certain bipolar patients, especially those recently unstable, may be more vulnerable to the impact of life events.