雙相情感障礙症（Bipolar disorder，以下簡稱躁鬱症）其預後(outcome)的評估，大都僅侷限於以復發(recurrence) 與否為標準。然而預後是多層面的(multi-dimensional)，整體預後(overall outcome) 應該涵蓋：疾病症狀(symptomatic outcome)、生理心理社會功能(functional outcome)與公共安全(public safety)對自己或他人的危險（意即自殺或死亡）。由於從西方的調查顯示躁鬱症是最常共發(co-morbid)物質濫用之精神疾病。因此以西方人之躁鬱症預後研究的結果，可能受到物質濫用的影響而難以呈現原貌。 　　內不同取樣來源均發現，雖然臺灣之躁鬱症患者物質濫用率約15%遠低於西方患者。然而，東西方患者的各層面預後卻差異不大，約有六分之一整體預後差、約有三分之一患者有社會功能退化、中年期以後有50%左右會合併一種以上的慢性生理疾病、60 歲以後緩解期個案有30%左右有認知功能退化、約有45%曾有過自殺企圖。此外東西方死亡研究均指出躁鬱症患者主要死因為自殺，其次為心臟血管疾病。以臺灣之躁鬱症死亡患者研究發現：自殺高危險期為發病後7-12年內或35歲以前；一級血親有自殺史且七年內有過自殺企圖為自殺死亡的危險因素。而急性期時肝酵素高、白血球數增加以及甲狀腺素升高均為提早自然死亡的危險因素，然而藥物治療除了促進整體預後，降低自殺死亡危險以外，也可能因改變疾病引起之生理反應(pathophysiology) 而可降低自然死亡的危險。

　　　　　The outcome measurement regarding bipolar disorder frequently focuses on whether there is a recurrence on the end-points. However, overall outcome measurement should be multi-dimensional and should cover symptomatic as well as, functional outcome and public safety (e.g. suicide, risk to others). The Chinese bipolar patients in Taiwan, unlike Western patients, are repeatedly found to exhibit a low comorbidity of alcohol/drug use disorders. The results of outcome study for bipolar disorder emerged from Taiwanese samples may be less influenced by substance abuse. 　　In Taiwan, there were about one sixth of bipolar patients considered to have a poor long-term overall outcome, one third having unfavorable psychosocial outcome, approximately 50% of the middle-aged patients having more than one kind of important chronic physical illness, cognitive dysfunction found in 30% of patients aged more than 60years, and 45% having prior suicidal history. Principal causes of mortality in bipolar disorder are suicide and circulatory diseases. The first seven to 12 years subsequent to onset of affective illness and age less than 35 years may be the high-risk periods for completing suicide. The in creasing white blood cell counts, higher levels of liver enzymes, particularly aspartate transaminase, and throxine in acute phase of bipolar disorder have predictive value on early natural death among clinical variables. Length of either antipsychotics or lithium treatment may reduce the risk of suicide along with natural dearth and full compliance with pharmacotherapy is crucial for achieving optimal overall outcome.