At+Risk+Populations

Like many physical or mental health problems early detection is paramount to successful treatment. Implementations such as primary prevention techniques that are applied to the general population can aid in the early detection of both physical or mental health issues.

When looking at Bipolar disorder (BPD), early identification and detection of the signs and symptoms of can essentially change the course of the illness. Bipolar disorder is characterized as a progressive disorder, where it worsens and accelerates the longer it is left unattended (Brietzke et al., 2012). Treatment success also becomes less efficacious in individuals who have suffered from untreated bipolar disorder for long periods of time.

//“…treatment delay in BPD (bipolar disorder), exposing the individual to more mood episodes, is related to poor social adjustment, higher number of hospitalizations, increased risk of suicide, development of comorbidities, forensic complications and decreased quality of life.” (Brietzke et al., 2012, p. 83)//

It is evident that early detection of bipolar disorder can contribute to therapeutic success and early intervention can increase the quality of life of individuals suffering from BPD. Thus, we must begin to identify populations at increased risk for Bipolar disorder in order to ensure that early intervention is possible.

In Brietzke et. al. ‘s article (2012) they suggest three categories that predict high risk factors for individuals to develop BPD. These categories include:


 * 1.) Genetic Factors** – Genes play a large role in the development of bipolar disorder, in fact it is considered one of the most heritable of all disorders (Davison, Blankstein, Flett, Neale, 2008). Individuals who have a family history of BPD are significantly more at risk than individuals who have no family members with BP. There is approximately an 80% likelihood of inheriting BPD if other members of the family, especially parents have BPD (Sprooten et. al, 2012). “Twin and adoption studies empirically support the notion that genetic factors are the vulnerability factor with the largest effect sizes” (Brietzke et al., 2012, p. 86).


 * 2.) Environmental Risk Factors** – There a number of environmental factors that could possibly contribute to the development of BPD. Many of these factors are also commonly attributed to the development of various other mental health issues as well. Childhood trauma is a significant risk factor. Physical and or sexual abuse, neglect (including both emotional neglect as well as children not receiving the necessary essentials of life such as food, clothing, school supplies etc.) and the loss of a parent are often significant risk factors (Brietzke et al., 2012). These things may impact the emotional and neuronal development of the child and thus can have various detrimental impacts on their psychological maturation.


 * 3.) Brain Structure** – Neuroimaging allows researchers to look at the physical structure of the brain to see if there are differences among individuals with BPD and control participants. The brain structures that are mainly thought to have an effect on bipolar disorder are: the amygdala, hippocampus, prefrontal cortex and the anterior cingulate (Davison, Blankstein, Flett, Neale, 2008). Some research has suggested that individuals with BPD have reduced grey matter and cerebral blood flow in the left subgenual anterior cingulate (Bruno, 2005). The brain-derived neurotrophic factor (BDNF gene) has been implicated in the development of BPD, as well as white matter abnormalities. These are just a few of the possible brain structure abnormalities that could be implicated in the development of BPD, however much more research needs to be done in order to substantiate the latter propositions.

It is important to note that these risk factors are additive. For example, an individual who has a family history of Bipolar disorder while simultaneously experiencing neglect and trauma as a child dramatically increases the probability of developing BPD. It is often the case that stress or traumatic life events do not solely cause the illness but rather they can trigger the illness in someone who is already predisposed to the it.