Prognostic Trajectories in Adolescent Bipolar Disorder During Remission: Interactions among Metacognition, Goal Orientation, and Social Support

Abstract

Background: Adolescent bipolar disorder (BD) is widely recognized as a severe psychiatric condition with a markedly elevated risk of relapse. Although a subset of patients attain symptom control during remission under clinical care, long-term prognostic trajectories still display substantial heterogeneity. Methods: To clarify determinants relevant to remission, this review systematically retrieved and compared literature via keyword-based searches across major databases, including Google Scholar and CNKI, spanning 2000–2025; classic theoretical works were also consulted to strengthen the conceptual foundation and to offer a more integrated perspective. Results: Evidence suggests that metacognition, goal orientation, and social support do not operate in isolation. Rather, they form a dynamic, mutually reinforcing cycle that exerts a marked influence on functional recovery among adolescents with BD during remission. Conclusion and Significance: The three factors emerge as core elements shaping remission outcomes and informing intervention design. They provide a robust theoretical basis together with practical implications for facilitating stable remission and for fostering more favorable long-term trajectories in adolescents with BD.