ipolar disorder (BPD), or manic-depressive psychosis, is a common and severe mental illness, with a lifetime prevalence of 1-2%. BPD is characterised by two types of recurrence, mania and depression. High rates of recurrence and associated adverse consequences occur in spite of a range of effective treatments. Early warning signs (EWS) interventions, targeted at improving the recognition and self-management of manic and depressive symptoms, are intended to train people with recurrent bipolar affective disorder to recognise early warning signs of recurrence and to avert adverse outcomes. This review demonstrated that these interventions, in addition to treatment as usual (TAU), including medication and regular appointments with health professionals, have benefits on time to recurrence and hospitalisation. Compared with TAU only, EWS interventions also resulted in improved functioning at eighteen months, although these data were sparse and the findings should be interpreted with caution. EWS interventions did not appear to have any effect on depressive or manic symptoms, although again, these findings were based on small numbers of potentially selected patients in remission. It should be noted that EWS was used along with other psychological interventions, and it is not entirely clear what proportion of the beneficial effect was due to the EWS intervention alone.