MANIC-DEPRESSIVE (BIPOLAR) DISORDER - THE COURSE IN LIGHT OF A PROSPECTIVE 10-YEAR FOLLOW-UP OF 131 PATIENTS

For a five-year period, 131 bipolar patients were followed every 6 mon ths; for the next 5 years, they were followed yearly. Each patient was interviewed in a systematic way that gave information about episodes, hospitalizations, cycle lengths and the presence of alcoholism. Women and men were not significantly different in the number of follow-up m anic or depressive episodes or hospitalizations. Chronicity from index episode to the end of the 10-year follow-up was uncommon (4%). Alcoho lism, which was common in these patients, showed a great diminution at the end of 10 years. Contrary to expectation, cycle lengths showed no systematic decrease in length over the follow-up. In this naturalisti c study, treatment intensity was not related to decreasing episodes or to changes in cycle length. The number of episodes in the first 5 yea rs of follow-up was not correlated with the number of episodes in the last 5 years. Cycle lengths in the first 5 years of follow-up were sim ilar in length to the last 5 years of follow-up. A family history of m ania in these bipolar patients was associated with more episodes in fo llow-up than if such a family history were absent. The patients whose alcoholism predated the onset of their affective illness were less lik ely to have episodes in the follow-up than the patients in whom affect ive illness predated the onset of the alcoholism.