Factors Protective factors Risk factors
Genetic loading
Absence of family history
Presence of Family history
Traits, temperament and predictors of bipolarity
Absence of trait bipolar (cyclothymia), hyperthymic temperament and predictors of bipolarity
Presence of trait bipolar, hyperthymic temperament and predictor of bipolarity
Age of onset
Advance age of onset (Rule out organicity)
Early age of onset
Social stressor
Absence of stressor
a. Presence of stressor [12] (Childhood events, Adulthood events, Acute stressor, Chronic stressor, Positive life events, Negative life events) b. Subjective perception of life events more important than life event itself
Social support
Presence of social network, social interaction and instrumental support
Poor social support
Marital status
Being married is protective as well as predictor for future separation
Being single, divorced or separated
Socioeconomic factors
Higher level of education, good income, living condition, employed status is protective (over-representation in bipolar II patients)
Lower socio-economic status (lower level of education, lower level of income, poorer living condition, higher level of unemployment)
Residence (Rural-Urban difference)
Rural communities (in relation to stressful life)
Urban communities
Substance use (Comorbid Axis I diagnosis)
Absence of alcohol abuse or dependence
Presence of alcohol abuse and dependence
Treatment adherence
Presence of treatment adherence
Absence of treatment adherence