This article proposes an alternative model for conceptualizing prodromal changes (the hybrid/interactive model) and discusses the different ways to view this phase.The need for a more systematic evaluation of the prodromal phase in first-episode psychosis is emphasized. The term "prodrome" is derived from the Greek word prodromos meaning the forerunner of an event (Fava and Kellner 1991).Early detailed descriptions, achieved through mainly anecdotal reports, are compared with current conceptualizations, such as the DSM-III-R checklist of mainly behavioral items, which seeks to enhance reliability of measurement but at the expense of adequately describing the full range of phenomena.Current confusion about the nature of prodromal features and concerns regarding the reliability of their measurement are highlighted.
In a 2005 survey of people with bipolar partners published in Bipolar Disorders, more than half of the participants reported that their partners illness had reduced their socializing, required them to assume more household responsibilities, forced them to take time off of work, and caused financial strain.The participants also reported that their sex lives sagged when their partner was in a manic or a depressive phase; three-quarters of the women who were interviewed and 53% of the men complained of infrequent sex when their spouses were depressed.Another study of bipolar caregivers found that 86% of the participants characterized the stress they experienced as a result of their partners illness as "major." And 9 out of 10 said they found it difficult to keep the relationship going.The episodes of depression and mania that bipolar people experiencewhich can lead to emotional withdrawal, out-of-the-blue accusations and outbursts, spending sprees, and everything in betweenhave been shown to induce stress, sexual dissatisfaction, and money worries in their partners, as well as depression. The answer is different for everyone Read more More about bipolar disorder "Mental illness is, on some levels, a contagious disease," says David Karp, Ph D, a professor of sociology at Boston College who has studied interpersonal dynamics within bipolar couples.Depressive phases, during which the bipolar partner feels hopeless and sad, can drag a healthy partner down, too. "It brings out very strong negative emotions and feelings of isolation in the partner, who struggles so hard to separate the illness from the patient." Relatively few studies have been conducted on the effects of bipolar disorder on relationships, but the research is nearly unanimous that the disorder tends to cause both practical and emotional difficulties for couples.