The aim of this study was to identify how different areas of function (role
performance, interpersonal relationships, sexual activity and recreational
enjoyment) differentially recover from a manic episode during the 8 months
following a first psychiatric hospitalization. Fifty patients with bipolar
disorder, 16 45 years of age, who met the criteria for a current manic epi
sode were recruited juring their first psychiatric hospitalization. Forty-t
wo (84%) of these participated in follow-up. Patients were evaluated using
structured and semi-structured clinical instruments and the four areas of f
unctional outcome were assessed with the LIFE interview. Recovery of the fo
ul areas of Function were compared using survival and correlational analyse
s. Logistic regression identified factors associated with Functional outcom
e. The four aspects of function were not significantly intercorrelated at b
aseline or during follow-up. Moreover, the survival curves for the differen
t areas of function significantly differed. Specifically, patients demonstr
ated better recovery of sexual activity and worse recovery of recreational
enjoyment than the other areas of function. Different clinical and demograp
hic variables predicted recovery of the different areas of function. In con
clusion, following a first manic episode, recovery of psychosocial function
can be divided into separate components, i.e., role function, interpersona
l relationships, sexual activity and recreational enjoyment, that appear to
be relatively independent. Further clarification of recovery of these diff
erent areas of function may lead to better integrated treatments that maxim
ize functional improvement early in the course of bipolar disorder. (C) 200
0 Elsevier Science Ltd. All rights reserved.