Manic‐depressive (bipolar) disorder: the course in light of a prospective ten‐year follow‐up of 131 patients

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Abstract
For a five‐year period, 131 bipolar patients were followed every 6 months; 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 manic or depressive episodes or hospitalizations. Chronicity from index episode to the end of the 10‐year follow‐up was uncommon (4%). Alcoholism, 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 naturalistic study, treatment intensity was not related to decreasing episodes or to changes in cycle length. The number of episodes in the first 5 years 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 similar in length to the last 5 years of follow‐up. A family history of mania in these bipolar patients was associated with more episodes in follow‐up than if such a family history were absent. The patients whose alcoholism predated the onset of their affective illness were less likely to have episodes in the follow‐up than the patients in whom affective illness predated the onset of the alcoholism.

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