BACKGROUND: The biopsychosocial approach to understanding the etiology and pathogenesis of affective disorders predetermines the importance of studying the relationship of social and mental factors, including the patient’s microsocial environment, and the course of disease. AIM: This review analyzes data from literature related to the psychological traits of the patient’s family environment and the relationship of these variables and indicators of the course of disease in affective disorders. MATERIALS AND METHODS: This review uses PRISMA criteria and requirements. Systematic online search in Pubmed, Google Scholar, ScienceDirect and eLibrary databases, and manual search of articles. RESULTS: The review includes 21 studies with a total of 3,166 respondents, including 2,320 patients and 846 family members. Patient distribution by diagnosis: bipolar disorder (65.90%), recurrent depressive disorder (20.52%), schizoaffective disorder (4.84%), other unspecified affective disorders (8.70%). Family member distribution by kinship: partners and spouses (57.1%), parents (20.2%), children (8.2%), siblings (1.9%), other relatives and family members acting as carers (12.6%). It was found that the nature of the patient’s family functioning was an important factor in assessing the course of affective disorders. Five relatively independent research areas were found. They describe the relationship of microsocial environment phenomena and the course of affective disorders, including social integration and support of the patient, general family functioning, emotional expression, types of attachment in the family, and disease burden. CONCLUSION: Further study of psychosocial factors in the context of the course of affective disorders appears to be a promising research area as it allows to identify important pathogenesis and sanogenesis aspects. There is a critical shortage of domestic research in this area, which is largely determined by the lack of psychognostic methods and evaluation technologies. Adaptation and development of such methods is important at the current development stage of clinical psychology. © 2024 Elsevier B.V., All rights reserved.