CLINICAL AND PSYCHOSOCIAL PREDICTORS OF RECURRENCE IN RECOVERED BIPOLAR AND UNIPOLAR DEPRESSIVES - A ONE-YEAR CONTROLLED PROSPECTIVE-STUDY

Unipolar and bipolar patients with a chronic illness pattern were inve stigated to evaluate the relevance of clinical and psychosocial risk f actors to predict subsequent recurrence. Self-esteem, social adjustmen t, social support and attributional style were assessed in 27 recovere d bipolar patients, 24 recovered unipolar patients maintained on lithi um or antidepressant prophylaxis and 26 healthy controls. They were fu rther interviewed every 2 months in a 1-year period in order to diagno se affective episodes according to Research Diagnostic Criteria. Survi val analyses and Cox's regressions demonstrated that being a unipolar patient and showing poor social adjustment were the strongest predicto rs of the occurrence of affective episodes. Self-esteem, social suppor t, attributional style and clinical characteristics, such as age at il lness onset, number of previous episodes or of previous hospitalizatio ns and presence of affective disorder in first-degree relatives, were not found to be risk factors for further recurrence. This study stress es the importance of social adjustment in evaluating the outcome of af fectively ill patients maintained on medication prophylaxis. (C) 1997 Elsevier Science Ireland Ltd.