Bipolar Recurrence Rate — MRCPsych Paper B MCQ
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Correct answer: D — Approximately 35%
The correct answer is D. A systematic review and meta-analysis specifically examining adults after recovery from a single manic or mixed episode found a pooled 1-year recurrence rate of 35% (95% CI 30–41%). Recurrence could be manic, depressive or mixed; it does not require a family history. Approximately 60% is closer to some longer follow-up estimates or individual-cohort findings, while approximately 90% may be quoted as a broad lifetime recurrence estimate in selected descriptions of bipolar disorder but is not a defensible 1-year figure. The original wording omitted the population, outcome definition and time horizon, making its claim of approximately 90% without treatment non-unique and inadequately supported. NICE nevertheless emphasises that bipolar disorder is commonly relapsing-remitting and that longer-term management should be discussed after each episode.
Reference: Kessing LV, Andersen PK, Vinberg M. Risk of recurrence after a single manic or mixed episode—a systematic review and meta-analysis. Bipolar Disorders. 2018;20(1):9–17. https://pubmed.ncbi.nlm.nih.gov/29239075/