From 70 to 90 per cent of episodes of affective illness recover within a few months even without treatment. The rest become chronic and may last for years. Prognosis is better if treatment begins early during the episode. Even if their first episode has recovered, 70-80 per cent of patients will suffer one or more further attacks at some stage in their lives. Some patients become ill at regular intervals, or at the same time each year, often spring or autumn. Bipolar patients may alternate between depressed and manic phases, or either type may be more frequent. The course for an individual patient is unpredictable.


Gilbody, S., Sheldon, T. and Wessely, S. (2006). Should we screen for depression? BMJ 332, 1027-1030.

Kendler, K. S., Thornton, L. M. and Gardner, C. O. (2001). Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression. Am J Psychiatry 158, 582-586. Ustun, T. B., Ayuso-Mateos, J. L., Chatterji, S. et al. (2004). Global burden of depressive disorders in the year 2000. Br J Psychiatry 184, 386-392.

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