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Stressful life events and affective illness

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Brostedt EM, Pedersen NL. Stressful life events and affective illness.

Acta Psychiatr Scand 2003: 107: 208–215. © Blackwell Munksgaard 2003. Objective: 

To investigate the association between the occurrence of affective illnesses and the number/type of experienced negative stressful life events in a twin material. A case–control study with an unrelated twin as control to the case and a co-twin control study were both undertaken with the same material. Method: 

Postal questionnaire responses were used for confirming diagnosis and to inventory stressful life events. Risk ratios (RR) for groups of events were calculated using conditional logistic regression. Results: 

A dose–response relationship was observed for the association between stressful life events and affective illness. The RRs for specific groups of exposures were higher in the co-twin control study and higher for dizygotic twin pairs than for monozygotic twin pairs. Conclusion: 

Individuals with a history of affective illness select themselves into high-risk environments, in part due to their genetic propensity to the disease. Thus, the association represents a classic genotype–environment correlation.

Keywords: bipolar disorder; depressive disorder; life change events; stress; twins

Document Type: Research Article


Affiliations: Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden

Publication date: March 1, 2003


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