Pessimistic tendencies predict bipolar disorder relapse

Relapse in people with bipolar disorder can be predicted accurately by their tendency towards having pessimistic beliefs, according to a new study involving UCL researchers. The results, published today in eLife , could provide an urgently needed tool for doctors to predict upcoming relapse and provide timely treatment. Bipolar disorder is characterised by successive periods of elation (mania) and depression, interspersed with asymptomatic phases, called euthymia. People who have shorter periods of asymptomatic euthymia are more likely to suffer disability, unemployment, hospitalisation and increased suicidal feelings. However, predicting relapses using existing clinical diagnostic tools or demographic information has proven largely ineffective in bipolar disorder. Lead author Dr Paolo Ossola (University of Parma, Italy) said: "It is already known that people with depression tend to give negative information more weight than positive information, leading to pessimistic views that may make symptoms worse. "We wanted to test the idea that, before symptomatic relapse occurs in bipolar disorder, patients show a specific pattern in the way they update their beliefs according to new information, and this pattern makes them more vulnerable to relapse." The team carried out a belief update task with 36 people with bipolar disorder and then monitored them every two months for five years to see when they developed symptoms of a relapse.