Recovery

How is recovery determined?
Recovery is a goal with multiple features, including remission of symptoms, functional recovery, prevention of relapse or recurrence of mood symptoms, and improved subjective quality of life.
Syndromal recovery is a pre-requisite for complete symptomatic remission. Syndromal recovery means that the person may have some residual symptoms, but no longer meets the criteria for a diagnosis of bipolar disorder by current standards. Symptomatic recovery or remission indicates any residual symptom would not be outside the normal range of experience for someone who never had a diagnosis of bipolar disorder.
What is the evidence for recovery in bipolar disorder?
Moderate quality evidence suggests rates of syndromal recovery are around 77% at 6 months, and up to 84% at 4 years following a first episode of mania in people diagnosed with bipolar disorder. Rates of symptomatic recovery are lower, with rates around 58% at 6 months, and 72% at 2 years.
April 2019
Fact Sheet Technical Commentary
NeuRA Libraries
-
Bipolar Disorders Library
- Assessment and diagnosis
-
Signs and symptoms
- General signs and symptoms
-
Cognition
- Attention
- Cognition and bipolar type
- Cognition and functioning
- Cognition and symptoms
- Cognition in bipolar versus depression
- Cognition in bipolar versus schizophrenia
- Cognition in children with bipolar disorder
- Cognition in first-episode bipolar disorder
- Cognition in late-life bipolar disorder
- Cognition in relatives
- Decision making
- Episodic future thinking
- Executive functioning
- Insight
- IQ and general cognition
- Language
- Learning
- Memory
- Metacognition
- Processing speed
- Reasoning
- Social cognition
- Visuospatial ability
-
Treatments
-
Physical
- Non-pharmaceutical
-
Pharmaceutical
- Mood stabilisers
- Antidepressants
- Antipsychotics
- Adjunctive and alternative treatments
-
Treatments for specific symptoms and populations
- Treatments during pregnancy and breastfeeding
- Treatments for aggression and agitation
- Treatments for bipolar II disorder
- Treatments for bipolar versus unipolar depression
- Treatments for children
- Treatments for cognitive symptoms
- Treatments for dual diagnosis
- Treatments for elderly patients
- Treatments for first-episode bipolar disorder
- Treatments for high-risk groups
- Treatments for medication resistance
- Treatments for mixed states
- Treatments for rapid cycling
- Treatments for relapse prevention
- Treatments for suicide and self-harm
- Other
- Psychosocial
-
Physical
-
Risk factors
- Antecedents
-
Environmental
- Adult life events
- Childbirth
- Childhood adversity
- Environmental toxins
- Ethnicity
- Familial factors
- Infectious agents
- Maternal diet during pregnancy
- Maternal illness during pregnancy
- Migration
- Obstetric complications
- Parental age
- Parental education
- Parental psychological factors
- Sibship
- Socioeconomic status
- Substance use
- Traumatic brain injury
- Urbanicity
- Winter birth
-
Illness course and outcomes
- Absconding
- Age at onset
- Attitudes to medication
- Creativity
- Criminal offending, aggression and violence
- Criminal victimisation
- Cultural differences
- Drug and alcohol use
- Employment
- First-episode bipolar disorder
- Functional outcomes
- Homelessness
- Hope
- Menopause
- Mortality
- Parenthood
- Pathways to care
- Pediatric bipolar disorder
- Physical activity
- Physical health monitoring
- Quality of care
- Quality of life
- Recovery
- Relapse
- Relationships
- Religiosity
- Smoking
- Stigma
- Suicide and self-harm
- Treatment non-adherence
- Treatment resistance
- Insights for families
-
Physical features
-
Functional changes
- Body functioning
-
Biochemical changes
- Brain pH and lactate
- Dopamine
- GABA
- Gut microbiota
- Homocysteine
- Hormonal changes
- Hypothalamic-pituitary-adrenal axis
- Infectious agents
- Inflammation and immune system dysfunction
- Insulin-like growth factor
- Leptin
- Lipids
- Neurometabolites
- Neuropeptides
- Neurotrophins
- NMDA receptor function
- Oxidative stress
- S100 proteins
- Serotonin
- Uric acid
- Cerebral blood flow and metabolism
- Electrophysiology
- Structural changes
-
Functional changes
-
Co-occurring conditions
- Mental disorders
-
Physical disorders
- Asthma
- Blood disorders
- Cancer
- Cerebrovascular disease
- Dementia
- Diabetes
- Epilepsy
- Fibromyalgia
- Heart disease
- Infectious diseases
- Irritable bowel syndrome
- Metabolic syndrome
- Multiple sclerosis
- Musculoskeletal and connective tissues
- Obesity
- Osteoporosis
- Pain
- Peripheral vascular disease
- Premenstrual syndrome
- Sleep apnea
- Thyroid disorders
- Visual impairment
- Wilson’s disease
- Substance use
- Epidemiology
- General information
-
Schizophrenia Library
- Assessment and diagnosis
-
Signs and symptoms
- General signs and symptoms
-
Cognition
- Attention
- Cognition in high-risk groups
- Cognition in schizophrenia and bipolar disorder
- Cognitive functioning related to symptoms
- Decision making
- Defeatist performance beliefs
- Episodic future thinking
- Executive functioning
- Information processing
- Insight
- IQ
- Language
- Learning
- Memory
- Metacognition
- Olfactory functioning
- Psychomotor ability
- Reasoning ability
- Rigidity
- Social cognition
- Time perception
- Tone perception
- Visuospatial ability
-
Treatments
-
Physical
-
Pharmaceutical
-
First-generation antipsychotics
- All antipsychotics versus placebo
- Benperidol
- Bromperidol
- Chlorpromazine
- Droperidol
- First versus second generation
- Flupentixol
- Fluphenazine
- Fluspirilene
- Haloperidol
- Levomepromazine
- Loxapine
- Metiapine
- Molindone
- Penfluridol
- Perazine
- Perphenazine
- Pimozide
- Piperacetazine
- Pipotiazine
- Sulpiride
- Thioridazine
- Trifluoperazine
- Zuclopenthixol
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Side effects
- Blood disorders
- Bone density
- Cancer
- Cardiometabolic changes and weight gain
- Catatonia
- Constipation
- Dysphagia
- Extrapyramidal
- Hyperprolactinaemia
- Hypersalivation
- Hyponatraemia
- Mortality
- Neuroleptic malignant syndrome
- Neutropenia
- Oculogyric crisis
- Pancreatitis
- Polycystic ovarian syndrome
- Sedation
- Seizures
- Sexual dysfunction
- Thyroid dysfunction
-
Second-generation antipsychotics
- All antipsychotics versus placebo
- Amisulpride
- Aripiprazole
- Asenapine
- Blonanserin
- Brexpiprazole
- Cariprazine
- Carpipramine
- Clocapramine
- Clotiapine
- Clozapine
- First versus second generation
- Iloperidone
- Lurasidone
- Mosapramine
- Olanzapine
- Paliperidone
- Perospirone
- Quetiapine
- Remoxipride
- Risperidone
- Second versus second generation
- Sertindole
- Ziprasidone
- Zotepine
-
Side effects
- Blood disorders
- Bone density
- Cancer
- Cardiometabolic changes and weight gain
- Catatonia
- Constipation
- Dysphagia
- Extrapyramidal
- Hyperprolactinaemia
- Hypersalivation
- Hypomania
- Hyponatraemia
- Mortality
- Neuroleptic malignant syndrome
- Neutropenia
- Oculogyric crisis
- Pancreatitis
- Polycystic ovarian syndrome
- Sedation
- Seizures
- Sexual dysfunction
- Thyroid dysfunction
-
Adjunctive treatments
- Adenosine modulators
- Amphetamines
- Analeptics
- Anticholinergic medications
- Anticonvulsants
- Anticraving agents
- Antidepressants
- Antiinflammatory medications
- Benzodiazepines
- Beta blockers
- Calcium channel blockers
- Cannabinoids
- Catecholamines
- Cholinergic medications
- Cholinesterase inhibitors
- Erythropoietin
- Essential fatty acids
- GABA agonists
- GHB
- Glutamate receptor modulators
- Herbal medicines
- Mood stabilisers
- Nicotine
- Oestrogen
- Oxytocin
- Promethazine
- Serotonin modulators
- Sodium nitroprusside
- Statins
- Testosterone
- Treatments for constipation
- Treatments for hyperprolactinaemia
- Treatments for hypersalivation
- Treatments for movement disorders
- Treatments for sexual dysfunction
- Treatments for sleep disturbance
- Treatments for smoking
- Treatments for weight gain
- Alternative treatments
-
Treatments for specific symptoms and populations
- For high-risk groups
- Treatments during pregnancy and breastfeeding
- Treatments for aggression and agitation
- Treatments for childhood and early-onset schizophrenia
- Treatments for cognitive symptoms
- Treatments for dual diagnosis
- Treatments for elderly people and people with late-onset schizophrenia
- Treatments for first-episode psychosis
- Treatments for high-risk groups
- Treatments for medication non-adherence
- Treatments for medication-resistant schizophrenia
- Treatments for negative symptoms
- Treatments for relapse prevention
- Treatments for schizoaffective disorder
- Other
-
First-generation antipsychotics
- Non-pharmaceutical
-
Pharmaceutical
-
Psychosocial
-
Therapies
- Acceptance and commitment therapy
- Advanced treatment directive
- Animal-assisted therapy
- Art and drama therapies
- Avatar therapy
- Case management
- Cognitive behavioural therapy
- Community care
- Cost
- Crisis intervention
- Dance therapy
- Day centres and day hospitals
- Dialectical behavioural therapy
- Distraction techniques
- Educational therapies
- Enriched intervention
- Family intervention
- Genetics counselling
- Group therapy
- Home-based care
- Hypnosis
- Inpatient and outpatient care
- Integrated care
- Life skills programs
- Metacognitive training
- Mindfulness
- Monetary incentives
- Morita therapy
- Music therapy
- Nidotherapy
- Open dialogue approach
- Peer support
- Physical restraint
- Prevention programs
- Problem solving skills training
- Psychodynamic psychotherapy
- Shared decision making
- Strengths-based delivery
- Supported housing
- Supportive therapy
- Telemental health
- Therapeutic relationship
- Token economies
- Trauma-focused therapies
- User-held records
- Virtual reality
-
Therapies for specific symptoms and populations
- For childhood onset and early onset schizophrenia
- For cognition
- For dual diagnosis
- For fathers with schizophrenia
- For first-episode psychosis
- For high-risk groups
- For insight
- For internalised stigma
- For mothers with schizophrenia
- For negative symptoms of schizophrenia
- For positive symptoms of schizophrenia
- For PTSD symptoms
- For smoking
- For social functioning
- For treatment non-adherence
- For unemployment
- For weight gain
-
Therapies
-
Physical
-
Risk factors
-
Antecedents
- Attention dysfunction
- Autonomic nervous system anomalies
- Behavioural disturbances and psychopathology
- Dermatoglyphic anomalies
- Eye tracking anomalies
- Face emotion processing anomalies
- Height and body mass index
- IQ and academic performance
- Mild physical anomalies
- Motor dysfunction
- Olfactory identification deficits
- Sleep disturbance
- Speech and hearing deficits
- Stress responsivity anomalies
-
Environmental
- Adult life events
- Childhood adversity
- Congenital rubella syndrome
- Environmental toxins
- Ethnicity
- Familial and environmental risk
- Family relationships
- Famine
- Infectious agents
- Latitude, climate and winter birth
- Marital status
- Maternal diet and body mass index
- Maternal illness during pregnancy
- Migration
- Obstetric complications
- Parental age at birth
- Parental education
- Parental psychological factors
- Sex differences
- Sibship
- Social capital
- Socioeconomic status
- Substance use
- Traumatic brain injury
- Urban environment
- Genetics
-
Antecedents
-
Illness course and outcomes
- Absconding
- Age at onset
- Childhood and early-onset schizophrenia
- Creativity
- Criminal offending, aggression and violence
- Criminal victimisation
- Cultural differences
- Diet
- Drug and alcohol use
- Duration of untreated psychosis
- Duration of untreated psychosis and outcomes
- Electronic device use
- Employment
- First-episode psychosis
- Functional outcomes
- Homelessness
- Hope
- Late-onset schizophrenia
- Loneliness
- Mortality
- Parenthood
- Pathways to care
- Physical activity
- Physical health monitoring
- Psychotic relapse
- Quality of care
- Quality of life
- Relationships
- Religiosity
- Remission and recovery
- Sex differences
- Smoking
- Stigma and attitudes towards mental health
- Suicide and self-harm
- Treatment adherence
- Treatment-resistant schizophrenia
- Insights for families
-
Physical features
-
Functional changes
- Body functioning
-
Biochemical changes
- Brain pH and lactate
- C-reactive proteins
- cAMP
- Cholesterol
- Dopamine
- Homocysteine
- Hormonal changes
- Hypothalamic-pituitary-adrenal axis
- Infectious agents
- Inflammation and the immune system
- Lipids
- Melatonin
- Neurometabolites
- Neurotrophins
- Nitric oxide
- NMDA receptor function
- Oxidative stress
- Oxytocin
- S100 Proteins
- Serotonin
- Synaptic proteins
- Vitamin B
- Vitamin D
- Zinc
- Cerebral blood flow and metabolism
- Electrophysiology
- Structural changes
- Brain regions
-
Functional changes
-
Co-occurring conditions
- Mental disorders
-
Physical disorders
- Auditory system dysfunction
- Autoimmune diseases
- Blood disorders
- Cancer
- Cerebrovascular disease
- Dementia
- Dental disease
- Diabetes
- Digestive disorders
- Epilepsy
- Heart disease
- Infectious diseases
- Metabolic syndrome
- Musculoskeletal and connective tissues
- Obesity
- Peripheral vascular disease
- Polycistic ovary syndrome
- Postoperative complications
- Reproductive and urological disorders
- Respiratory system dysfunction
- Skin disorders
- Sleep apnea
- Thyroid disorders
- Underweight
- Visual impairment
- Substance use
- Epidemiology
- General information
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.