The analysis of the medical records of 402 patients with a primary episode of bipolar aff ective disorder revealed early onset of the disease, low educational, occupational and social levels of patients, as well as high aff ection by their addictive behavior. Characteristics of these changes depend on the clinical variant of the initial episode and are the worst in patients with mixed and manic variants, and relatively better — in patients with depressive variant of the initial episode. During life, the level of professional, social and family implementation of patients remains low, with the worst social consequences of the disease in patients with a manic and mixed variant of the initial episode, and relatively better — in patients with depressive variant. These features should be taken into account when developing diagnostic, therapeutic and prophylactic approaches.