{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:31:23Z","timestamp":1789446683212,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,11,28]],"date-time":"2015-11-28T00:00:00Z","timestamp":1448668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["MH29618"],"award-info":[{"award-number":["MH29618"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01MH096944"],"award-info":[{"award-number":["K01MH096944"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["HL082610"],"award-info":[{"award-number":["HL082610"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>As outlined in the social zeitgeber hypothesis, social rhythm disrupting (<jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content>) life events begin a cascade of social and biological rhythm disruption that may lead to the onset of affective episodes in those vulnerable to bipolar disorder. Thus, the study of <jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content> events is particularly important in individuals with this chronic condition. The purpose of the current study was to evaluate (i) the extent to which <jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content> life events increased the risk of recurrence of a bipolar mood episode, and (ii) whether the social rhythm disruption associated with the event conferred an increased risk of recurrence, after accounting for the level of threat associated with the life event.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined the effect of <jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content> events on recurrence during preventative treatment in a sample of 118 patients with bipolar disorder who achieved remission from an acute episode after receiving psychotherapy and pharmacotherapy. Life events were measured with the Bedford College Life Events and Difficulty Schedule and were rated for degree of <jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content> and threat.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Time\u2010dependent Cox proportional hazards models showed that having a higher <jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content> rating was significantly associated with an increased risk of recurrence, even when accounting for the threat effect of a life event and psychosocial treatment (hazard ratio\u00a0=\u00a01.33, 95% confidence interval: 1.04\u20131.70, p\u00a0=\u00a00.023). However, this finding fell below conventional levels of statistical significance when accounting for other covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings lend partial support to the social zeitgeber hypothesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12351","type":"journal-article","created":{"date-parts":[[2015,11,28]],"date-time":"2015-11-28T07:08:46Z","timestamp":1448694526000},"page":"869-879","source":"Crossref","is-referenced-by-count":22,"title":["Social rhythm disrupting events increase the risk of recurrence among individuals with bipolar disorder"],"prefix":"10.1111","volume":"17","author":[{"given":"Jessica C","family":"Levenson","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith L","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara P","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Kupfer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA USA"},{"name":"Department of Psychology University of Pittsburgh Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-0179-5-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60512-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61611-6"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.5.543"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(00)00894-5"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2850.2009.01160.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2008.05.084"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1093\/clinchem\/40.2.303","article-title":"Brain mechanisms in manic depression","volume":"40","author":"Carroll BJ","year":"1994","journal-title":"Clin Chem"},{"key":"e_1_2_8_10_1","volume-title":"Manic\u2010Depressive Illness: Bipolar Disorders and Recurrent Depression","author":"Goodwin FK","year":"2007"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2005.06.006"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2005.06.004"},{"key":"e_1_2_8_13_1","first-page":"409","article-title":"NIMH workshop report on treatment of bipolar disorder","volume":"26","author":"Prien RF","year":"1990","journal-title":"Psychopharmacol Bull"},{"key":"e_1_2_8_14_1","volume-title":"Social Origins of Depression: A\u00a0Study of Psychiatric Disorder in Women","author":"Brown GW","year":"1978"},{"key":"e_1_2_8_15_1","volume-title":"Life Events and Illness","author":"Brown GW","year":"1989"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.10.051"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1988.01800340076012"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/depr.3050010602"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199002000-00007"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(91)90131-8"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1176\/ajp.2006.163.6.981","article-title":"The importance of routine for preventing recurrence in bipolar disorder","volume":"163","author":"Frank E","year":"2006","journal-title":"Am J Psychiatry"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(96)00241-7"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.8.702"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2008.04.003"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.9.996"},{"key":"e_1_2_8_26_1","volume-title":"Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy","author":"Frank E","year":"2005"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20371"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.4.419"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1978.01770300115013"},{"key":"e_1_2_8_30_1","volume-title":"Dictionary of Behavioral Assessment Techniques","author":"Raskin A","year":"1988"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-196901000-00010"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.1959.tb00467.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1979.tb04484.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1978.01770310043002"},{"key":"e_1_2_8_35_1","volume-title":"Structured Clinical Interview for DSM\u2010IV Axis I Disorders SCID I: Clinician Version, Administration Booklet","author":"First MB","year":"1997"},{"key":"e_1_2_8_36_1","first-page":"17","article-title":"Clinical significance of reversed vegetative subtypes of recurrent major depression","volume":"27","author":"Thase ME","year":"1991","journal-title":"Psychopharmacol Bull"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1994.03950070017006"},{"key":"e_1_2_8_38_1","volume-title":"Life Events and Illness","author":"Harris TO","year":"1989"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.162.3.358"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.1.8"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2012.07.009"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0012862"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.03.012"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2869.2002.00300.x"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbdi.12351","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.12351","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T17:54:23Z","timestamp":1696269263000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bdi.12351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,28]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1111\/bdi.12351"],"URL":"https:\/\/doi.org\/10.1111\/bdi.12351","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,28]]}}}