The authors report the results of a followup study of manic-depressive and schizoaffective psychoses after systemic family therapy. They describe the development of inpatient relapse rates, familial interactional patterns, and prescriptions of medication in a sample of 30 cases treated with family therapy and followed up after a mean interval of 3 years. Finally, they assess the effectiveness of systemic family therapy with manic-depressive and schizoaffective psychoses.

This article reports the authors' observations on 22 families in which a young adult member has been diagnosed as manic-depressive, and on 11 families in which a member has been diagnosed as suffering from major schizoaffective disorder. All families could be described as extremely rigid and bound-up systems. Many of them were characterized by a "restrictive parental complementarity" and reciprocal delegation, and they shared certain cognitive features and assumptions. "Manic-depressive" families showed similarities as well as differences when compared with families in which there were schizophrenic and serious psychosomatic disorders.

This is a companion piece to the article "Some Features of Families with Major Affective Disorders," published in Family Process (25: 325-336, 1986). In addition to the family features mentioned in the first article, the authors report on other features that have come to the fore since then. Subsequently, they deal with the therapeutic problems that derive from all of these features. In particular, they elaborate on how the therapists must (and can) maintain their neutrality in the face of the massive polarizations and extremes of the either/or thinking found in these families. There follows a description of typical phases in the therapeutic process. Finally, therapy with one family is described in detail.

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