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Stability of lithium treatment in bipolar disorder - long-term follow-up of 346 patients.

Berghöfer A, Alda M, Adli M, Baethge C, Bauer M, Bschor T, Grof P, Müller-Oerlinghausen B, Rybakowski JK, Suwalska A, Pfennig A - Int J Bipolar Disord (2013)

Bottom Line: Wald tests were used to assess the significance of fixed effects and covariates when analyzing the relationship between depressive, manic, and total morbidity index and several characteristics of illness course.The drop-out rate was high over the study period.Our findings suggest that long-term response to lithium maintenance treatment remains stable over time.

View Article: PubMed Central - PubMed

Affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, 10098 Germany.

ABSTRACT

Background: The purpose of this study was to investigate the effectiveness and stability of long-term lithium treatment in a prospective, international, multicenter cohort of bipolar patients in a naturalistic setting.

Methods: Patients were selected according to DSM IV criteria for bipolar disorder and required long-term treatment. They were prospectively followed and documented in five centers belonging to the International Group for the Study of Lithium-Treated Patients. This was a prospective cohort study without a comparison group. Lithium treatment was administered in a naturalistic and specialized outpatient setting. All patients underwent a comprehensive psychiatric examination, which included the use of standard rating scales, as well as an evaluation of clinical course based on the morbidity index (MI). Wald tests were used to assess the significance of fixed effects and covariates when analyzing the relationship between depressive, manic, and total morbidity index and several characteristics of illness course.

Results and discussion: A total of 346 patients with bipolar disorder I or II were followed for a mean period of 10.0 years (standard deviation (SD) 6.2, range 1 to 20). The morbidity index remained stable over time: the mean MI was 0.125 (SD 0.299) in year 1 and 0.110 (SD 0.267) in year 20. The MI was not associated with the duration of lithium treatment, the number or frequency of episodes prior to treatment, or latency from the onset of bipolar disorder to the start of lithium treatment. The drop-out rate was high over the study period. Our findings suggest that long-term response to lithium maintenance treatment remains stable over time.

No MeSH data available.


Related in: MedlinePlus

Morbidity index over 20-year observation period. Black lines show mean (SD) morbidity index for all affective episodes (MItotal); gray bars show number of subjects in the analysis contributing to the morbidity index each year.
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Fig1: Morbidity index over 20-year observation period. Black lines show mean (SD) morbidity index for all affective episodes (MItotal); gray bars show number of subjects in the analysis contributing to the morbidity index each year.

Mentions: In the present study, a total of 346 patients were followed up for a mean period of 10 years (range, 1 to 20 years) on lithium treatment (Figure 1). The number of subjects varied between the participating treatment centers (Berlin n = 151, Halifax n = 35, Hamilton n = 14, Ottawa n = 75, and Poznan n = 71). Patients' baseline characteristics are given in Table 1. The mean age at the onset of bipolar disorder was 29, and lithium treatment was initiated with a mean latency of 10 years. For all 346 patients, the mean MItotal decreased slightly (i.e., from 0.125 to 0.110) over the 20-year observation period.Figure 1


Stability of lithium treatment in bipolar disorder - long-term follow-up of 346 patients.

Berghöfer A, Alda M, Adli M, Baethge C, Bauer M, Bschor T, Grof P, Müller-Oerlinghausen B, Rybakowski JK, Suwalska A, Pfennig A - Int J Bipolar Disord (2013)

Morbidity index over 20-year observation period. Black lines show mean (SD) morbidity index for all affective episodes (MItotal); gray bars show number of subjects in the analysis contributing to the morbidity index each year.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230691&req=5

Fig1: Morbidity index over 20-year observation period. Black lines show mean (SD) morbidity index for all affective episodes (MItotal); gray bars show number of subjects in the analysis contributing to the morbidity index each year.
Mentions: In the present study, a total of 346 patients were followed up for a mean period of 10 years (range, 1 to 20 years) on lithium treatment (Figure 1). The number of subjects varied between the participating treatment centers (Berlin n = 151, Halifax n = 35, Hamilton n = 14, Ottawa n = 75, and Poznan n = 71). Patients' baseline characteristics are given in Table 1. The mean age at the onset of bipolar disorder was 29, and lithium treatment was initiated with a mean latency of 10 years. For all 346 patients, the mean MItotal decreased slightly (i.e., from 0.125 to 0.110) over the 20-year observation period.Figure 1

Bottom Line: Wald tests were used to assess the significance of fixed effects and covariates when analyzing the relationship between depressive, manic, and total morbidity index and several characteristics of illness course.The drop-out rate was high over the study period.Our findings suggest that long-term response to lithium maintenance treatment remains stable over time.

View Article: PubMed Central - PubMed

Affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, 10098 Germany.

ABSTRACT

Background: The purpose of this study was to investigate the effectiveness and stability of long-term lithium treatment in a prospective, international, multicenter cohort of bipolar patients in a naturalistic setting.

Methods: Patients were selected according to DSM IV criteria for bipolar disorder and required long-term treatment. They were prospectively followed and documented in five centers belonging to the International Group for the Study of Lithium-Treated Patients. This was a prospective cohort study without a comparison group. Lithium treatment was administered in a naturalistic and specialized outpatient setting. All patients underwent a comprehensive psychiatric examination, which included the use of standard rating scales, as well as an evaluation of clinical course based on the morbidity index (MI). Wald tests were used to assess the significance of fixed effects and covariates when analyzing the relationship between depressive, manic, and total morbidity index and several characteristics of illness course.

Results and discussion: A total of 346 patients with bipolar disorder I or II were followed for a mean period of 10.0 years (standard deviation (SD) 6.2, range 1 to 20). The morbidity index remained stable over time: the mean MI was 0.125 (SD 0.299) in year 1 and 0.110 (SD 0.267) in year 20. The MI was not associated with the duration of lithium treatment, the number or frequency of episodes prior to treatment, or latency from the onset of bipolar disorder to the start of lithium treatment. The drop-out rate was high over the study period. Our findings suggest that long-term response to lithium maintenance treatment remains stable over time.

No MeSH data available.


Related in: MedlinePlus