PSYCHOSOCIAL PREDICTORS OF MAJOR AFFECTIVE RECURRENCES IN BIPOLAR DISORDER - A 4-YEAR LONGITUDINAL-STUDY OF PATIENTS ON PROPHYLACTIC TREATMENT

A total of 21 recovered bipolar patients on prophylactic treatment wer e prospectively followed up for a period of 1 year. Data for major rec urrences were retrospectively collected for an additional 3-year perio d. During the entire 4-year period, over half of the patients (52%) ha d no major affective recurrences. Eight patients experienced a major d epressive episode, while only two experienced a manic one. Psychosocia l and clinical variables were assessed at entry to the study. The effe ct of these variables on the subsequent 4-year illness course was anal ysed using survivorship curves. The results show that the following ps ychosocial variables significantly predicted the occurrence of a major affective episode: low level of social support, maladjustment in soci al and leisure activities, and poor quality of relationships with exte nded family. In contrast, clinical variables which characterize illnes s history were not significantly associated with major recurrences.