Course and Outcome of Bipolar Disorder: Focus on Depressive Aspects

  • Rodrigo Escalona
  • Mauricio TohenEmail author
Part of the Milestones in Drug Therapy book series (MDT)


The presence of depressive symptoms dominates the longitudinal course of bipolar disorder (BD) and predicts functional impairment. Despite great progress in understanding the biological basis of BD, the course and outcome of the illness can only be predicted using clinical variables. This chapter summarizes the main factors that predict course and outcome in BD with a focus on depressive symptoms. The natural course of the illness, the impact of the first episode, the impact of the depressive phase, cycle length, onset, age, gender, type of illness, personality traits, temperament, comorbidity, family history, life events, and outcome features will be reviewed. Conceptual models such as disease staging and their prognostic value will also be discussed.


Bipolar disorder Course Outcome Predictors Mixed depression Clinical diagnosis 



Dr. Tohen was a full-time employee at Lilly (1997–2008). He has received honoraria from, or consulted for, Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Lilly, Johnson & Johnson, Otsuka, Merck, Sunovion, Forest, Gedeon Richter Plc, Roche, Elan, Alkermes, Lundbeck, Teva, Pamlab, Wyeth, and Wiley Publishing. His spouse was a full-time employee at Lilly (1998–2013). Dr. Escalona has no conflict of interest to disclose, financial or otherwise.


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© Springer International Publishing Switzerland (outside the USA)  2016

Authors and Affiliations

  1. 1.Department of Psychiatry & Behavioral SciencesHealth Sciences Center, University of New MexicoAlbuquerqueUSA
  2. 2.New Mexico Veteran Affairs Health Care SystemAlbuquerqueUSA

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