The schizoaffective disorder worsens at the start of treatment

Psychiatry, Psychosomatics & Psychotherapy

However different a bipolar disorder may be from patient to patient, it always runs in phases or episodes in which a certain mood prevails (manic or depressive). The individual phases often come and go at irregular intervals. On average, the depressive phases last about four to twelve months without treatment, the manic phases are significantly shorter. Occasionally, manic or depressive episodes merge or even occur at the same time (mixed phase). Between the acute episodes of the illness there are more or less long periods of time, depending on the course, in which the affected person has no symptoms whatsoever. Suicide attempts and suicides almost always occur during or immediately after depressive or mixed phases.

Psychotic symptoms such as delusions indicate an unfavorable course of the bipolar illness: those affected suffer two to three times more relapses than bipolar patients without psychotic symptoms and about two thirds develop psychotic signs again with the next mania. In the case of rapid cycling, the long-term prognosis is often poor, as the unstable mood often persists between the phases. Those affected therefore have severe problems coping with everyday life. Most patients with bipolar disease regain their quality of life with individually tailored therapy.