Psycho-social dysfunctions in patients after recovery from mania and depression

Contrary to popular opinion, complete functional recovery does not occur in approximately 25% of patients with a diagnosis of mood disorders. The current study aimed at finding the recovery status in major mood disorders. A sample group of 122 patients (77 bipolar and 45 major depression) was selected from the outpatient department, fulfilling the DSM-IV diagnostic criteria. All patients had their index episodes at least one year prior to their date of inclusion and were either asymptomatic or mildly symptomatic during that time. Manics and depressives were rated with the Bech Raefelson Mania Scale (BRMS) and Hamilton Depression Rating Scale (HDRS) respectively. All the patients were also rated on the Brief Psychiatric Rating Scale (BPRS), Dysfunction Analysis Questionnaire (DAQ) and Global Evaluation Scale of Disability Assessment Schedule by WHO (GES/DAS). They were compared with 40 age and sex matched normal controls. It was found that the symptomatic recovery was better than the functional recovery in both manics and depressives and patients with major depression were marginally more dysfunctional compared to those with mania. It is concluded that a majority of patients of both mania and depression do not achieve complete functional recovery and are in need of on-going psychosocial rehabilitation.