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Despite modern drug treatment, bipolar disorder (manic-depressive
psychosis) has a high rate of relapse. Prodromes, or early symptoms of
relapse, consistently appear before mania and depression. On p 149
Perry et al show that training patients to recognise prodromes and seek
early treatment reduces the number of manic relapses and improves both
social function and employment. Such training does not reduce the
number of depressive relapses. Recognition and early treatment of manic
prodromes is efficacious, but cost effectiveness studies are
required before the treatment is systematically introduced into the NHS.