Recurrent Affective Syndromes in Bipolar and Unipolar Mood Disorders at Follow-Up

BACKGROUND: It is in dispute whether affective relapse disrupts psychosocial functioning to the same extent in depressed and manic patients. METHOD: A prospective, naturalistic, longitudinal follow-up of 84 unipolar and bipolar affectively disordered in-patients was conducted to examine the extent of recurrent affective syndromes and their relationship to overall outcome. Global adjustment relative to relapse was assessed at 2- and 4.5-year follow-ups. RESULTS: Nearly half of the bipolar patients had subsequent syndromes, which were often associated with uniformly poor psychosocial functioning. Fewer than one-quarter of those with recurrences had steady work performance. Bipolar patients taking lithium alone had fewer recurrences than those taking lithium as well as neuroleptics (P < 0.05). Bipolar and unipolar patients relapsed with equal frequency, but unipolar relapse was less often associated with readmission to hospital, work impairment, or uniformly poor functioning. CONCLUSION: Affective relapse in bipolar disorders was more detrimental to overall functioning than was recurrence in unipolar depression.