This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .
Relapse and impairment in bipolar disorder.
OBJECTIVE The purpose of this study was to evaluate the outcome of bipolar disorder in the context of maintenance pharmacotherapy . METHOD Eighty-two bipolar out patients were followed prospect ively for a mean of 4.3 years ( minimum of 2 years ) ; symptom rating and psychosocial outcome scales were used , and pharmacotherapy was rated on a 5-point scale . RESULTS Despite continual maintenance treatment , survival analysis indicated a 5-year risk of relapse into mania or depression of 73 % . Of those who relapsed , two-thirds had multiple relapses . Relapse could not be attributed to inadequate medication . Even for those who did not relapse , considerable affective morbidity was observed . A measure of cumulative affective morbidity appeared to be a more sensitive correlate of psychosocial functioning than was the number of relapses . Poor psychosocial outcome paralleled poor syndromal course . Poor psychosocial functioning , especially occupational disruption , predicted a shorter time to relapse . Depressions were most strongly related to social and family dysfunction . CONCLUSIONS Even aggressive pharmacological maintenance treatment does not prevent relatively poor outcome in a significant number of bipolar patients
This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .