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Advances in Psychiatric Treatment (2004) 10: 18-26
© 2004 The Royal College of Psychiatrists

The early warning symptom intervention for patients with bipolar affective disorder

Richard Morriss

Richard Morriss has been Professor of Psychiatry and Head of Department at the University of Liverpool (Department of Psychiatry, 2nd Floor, Royal Liverpool University Hospital, Liverpool L69 3GA, UK) and an honorary consultant psychiatrist for Mersey Care NHS Trust since 1999. He has research and clinical interests in affective and somatoform disorders.

Randomised controlled trials and surveys of patients’ experiences indicate that the recognition and prompt treatment of early warning signs of relapse in selected patients with bipolar affective disorder are effective in lengthening the time to the next manic relapse and improving function. Improvements in patient coping mechanisms allied to these techniques can prevent some depressive episodes. The intervention is described in some detail and conditions under which it is most likely to be effective or to fail are reviewed. If the intervention is to be successful, patients must be carefully selected, early warning signs and symptoms must be analysed in detail, it must be a central feature of the care plan and the service must be ready to respond quickly to a patient’s early warning symptoms.




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