Dealing with persisting abnormalities of mood

Abstract

A significant minority (between 12-20%) of patients with affective disorder suffer from persisting abnormalities of mood. Individuals with these disorders represent a heterogeneous group spanning the neuroses and the psychoses. This review outlines our current knowledge of the aetiology and classification of persistent mood disorders. The most prevalent persistent abnormality in bipolar patients is rapid cycling disorder, whilst those with unipolar illnesses are more likely to suffer from chronic depression. The management of these two problems is discussed in detail. Although these patients fall into the ‘difficult to treat’ category, recent research suggests that multimodal treatment including optimal pharmacotherapy and appropriate psychosocial interventions can lead to significant improvement in at least 50% of cases.