There is probably no higher degree of devastating disruption to productivity and family stability than the periodic recrudescence of manic-depressive episodes necessitating hospitalization. Although the affective psychotic episode may leave no clinical residuals, there is increasing evidence that negative psychosocial facets of affective disorder are considerable. As so aptly expressed by Aubrey Lewis, however, it would be ‘misconceived to equate ill health with social deviance or maladjustment’. 44 patients who attended the lithium clinic for treatment of an affective disorder were investigated for psychosocial morbidity. Several well-known studies were analyzed with respect to selected psychosocial variables. The findings of this study were in accord with what has been reported on significant differences between bipolar and unipolar cases with respect to the following: bipolar cases have a lower age of onset, more hospitalizations, a positive family history of mania, a higher attempted suicide rate, higher social class, and a higher divorce rate. This study did not confirm reported findings with regard to a causal relationship between stressful events and hospitalization, loss of relative prior to age 15 or that a majority of first episodes in bipolar cases were of a depressive type. Other findings emerging from this study include a high incidence of alcoholism both in family history as well as in probands, among all subtypes; high rate of job and residential mobility notably among bipolar patients, and a consistently high self image among bipolar patients in contrast to a ‘low’ self image among unipolar patients. Relatives report marked improvement in psychosocial stability of patients during lithium treatment.