Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment

Editor - Perry et al have produced a significant contribution into
our understanding of prodromal symptoms in patients who have relapsing
manic- depressive psychosis.1 My practice operates a personal list system
and 1 have been observing my patients for the past 8 years. Increasingly I
am aware that most of my patients with relapsing psychosis will visit me
with recurrent idiosyncratic symptoms in the 2 weeks prior to relapse. By
recording of this events I have found that using pattern recognition of
language and body posture I am able to intervene to prevent relapse. I
think
this is a result of continued care with one individual using a personal
list system. I believe that not only patients but also general
practitioners also need to be trained in prodomal symptom recognition and
the study needs to be
repeated in a primary care setting.

Dr Matthew Hoghton
General Practitioner MRCGP

1 Perry A,Tarrier N, Morriss R, McCarthy E, Limb K Randomised
controlled trial of efficacy of teaching patients with bipolar disorder to
identify early symptoms of relapse and obtain treatment BMJ 1999;318:149-
53