ABSTRACT
The longitudinal course of bipolar disorder is defined by recurrent manic and depressive mood episodes. Clinicians treating patients with bipolar disorder are observant of the severe impact these mood episodes have on the lives of patients and their families, including job performance and personal relationships and responsibilities. Despite the magnitude of the impact of mood episodes on day-to-day function, most bipolar disorder studies conducted to date have examined measures of symptoms and syndromal outcome as opposed to more patient-relevant functional improvement. Nonetheless, the study of functional outcome is critical: a recent study has shown that, 12 months after hospitalization for bipolar disorder, syndromal recovery measured 61.0%, whereas functional recovery was reported at only 36.0%.1 Restoration of pre-episode quality of life and level of functioning is of primary importance to the bipolar patient and should therefore serve as the guiding principle in the study and treatment of bipolar disorder. This chapter discusses prospective studies conducted at McLean Hospital in Belmont, Massachusetts that examined functional recovery and sought to determine predictors of functional outcome in patients with bipolar disorder.
