The assessment and prediction of outcome in affective disorders.
A prospective study of the course and outcome of illness of 126 patients admitted to hospital with affective disorders is described. Each patient was interviewed during the illness and at follow-up; the mean duration of the follow-up period was 3.8 years. On each occasion the clinical features were systematically rated and a descriptive account of the history was obtained.

Two aspects of prognosis were studied. First, the course and outcome of the group was examined by means of a longitudinal measure of outcome which reflected the average level of adjustment throughout the follow-up period. On the basis of this measure 60 per cent of the patients were considered to have been improved during the course of the follow-up period. Second, items of predictive importance were isolated and their relative predictive value determined. Constitutional factors were found to be important, premorbid stability of personality being related to a good outcome. The presence during the illness of features generally associated with depression was related to a good prognosis, whereas those associated with anxiety were related to a poor prognosis. The relative contributions to the prediction of outcome made by constitutional factors and features of illness were examined.

A predictive scale for affective disorders consisting of 11 weighted item scores was derived. It is suggested that the validity of this requires evaluation in further series of patients with affective disorders.