Les facteurs de risque familiaux influençant le cours et l'évolution du trouble bipolaire : revue de la littérature

The dysfunction in the families of the bipolar persons is more and more considered as being an important environmental factor influencing the course and the evolution of the disease. The objective of this article is to revise studies conducted on bipolar patients and their families, assessing the impact of the family environment on the course and the evolution of the bipolar disorder. We found that the family of bipolar patients is described as having a high level of conflict and a low level of cohesion and expression. The parents who have a high level of emotional expression (EE), who make personal criticisms, who have a negative nonverbal attitude, and a universal causal attribution of the disease, can precipitate the relapse of their children. The childhood abuse of these patients at an early age can be positively correlated with a rapid cycle of bipolar disorder, a dependence on a substance, a suicide attempt, a PTSD and hallucinatory symptoms. A family atmosphere, characterized by one or some of these risk factors, shapes the severity of the disease of the subjects affected by bipolar disorder.