Background. Patients suffering from bipolar affective
disorders are generally reported to be able to
detect prodromes. Insight is also said to be desirable for a good outcome.
However, very little is
known about the effect of insight and patients' spontaneous
strategies for coping with prodromes on their social functioning.
Method. In a cross-sectional study 40 bipolar patients, who
were not in an acute episode, were
interviewed about their prodromes of depression and mania, their coping
strategies for these
prodromes, their levels of insight and their levels of social functioning.
Results. A quarter of subjects reported that they could not
detect any early warnings of depression
compared with only 7·5% of subjects who reported that they could
not detect prodromes of
mania. Subjects reported both spontaneous cognitive and behavioural
strategies for coping with
prodromes of depression but only behavioural strategies for prodromes of
mania. Subjects' current
levels of depression, how they coped with prodromes of mania and their
ability to recognize early
warnings for depression contributed significantly to their level of social
functioning. Insight also had a weaker but significant contribution.
Conclusion. No causal link was made in this study. However,
show that patients' level of social
functioning was related to their level of insight, and to how well they
coped with the prodromes of
mania and whether they could detect prodromes of depression. The results
suggest that it is worth
exploring ways of teaching patients to monitor their moods and to promote
insight and good strategies for coping with their prodromes.