{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:25:52Z","timestamp":1783117552855,"version":"3.54.6"},"reference-count":65,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: A deeper comprehension of the role that environmental risk factors play in the development of adolescent Bipolar Disorder (BD), as well as in the evolution of high-risk states for BD, may entangle further prevention and treatment advances. The present systematic review is aimed at critically summarizing evidence about the role that environmental risk factors play in the development of BD in adolescence and their interaction with BD high-risk states. Materials and Methods: MEDLINE\/Pubmed, Scopus and Web of Science datasets were systematically searched until 4 September 2020. Original studies that reported information about the role of environmental risk factors in the development of BD during adolescence, or assessing their influence on the development of psychopathology in high-risk states for BD, were considered for inclusion. Two blind researchers performed title\/abstract, full-text screening, and hand-screening of relevant references. The risk of bias was assessed by means of the Newcastle-Ottawa Scale. Results: Fourteen studies were included in the review. Negative stressful life events, particularly sexual and physical abuse, but also emotional mistreatment, were associated with more severe psychopathology in adolescents with BD, as well as with higher risk for developing mood disorders in BD offspring. Similar findings were detected for familial environment-related features, such as parental rejection and low perceived care, while no univocal results were found when analyzing familial functioning. Conclusions: The present systematic review confirmed the relevant role that environmental risk factors, particularly negative stressful live events and family-related features, play in the development of BD psychopathology during adolescence. Future studies are expected to clarify possible further environmental factors that may be implicated in the development of BD during youth that may serve as target of prevention and early treatment strategies.<\/jats:p>","DOI":"10.3390\/medicina56120689","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T20:56:57Z","timestamp":1607893017000},"page":"689","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Environmental Risk Factors for Bipolar Disorders and High-Risk States in Adolescence: A Systematic Review"],"prefix":"10.3390","volume":"56","author":[{"given":"Giulia","family":"Menculini","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfrancesco Maria","family":"Balducci","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy"},{"name":"CSM Terni, Department of Mental Health, AUSL Umbria 2, Via Bramante 40, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5976-6738","authenticated-orcid":false,"given":"Luigi","family":"Attademo","sequence":"additional","affiliation":[{"name":"SPDC Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, Via Petrone, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Bernardini","sequence":"additional","affiliation":[{"name":"Department of Mental Health, AsFO Friuli Occidentale, Via Vecchia Ceramica 1, 33170 Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Moretti","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Tortorella","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1089\/cap.2017.0058","article-title":"Early-Onset Bipolar Disorder: Characteristics and Outcomes in the Clinic","volume":"27","author":"Connor","year":"2017","journal-title":"J. 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