Predictors of lithium prophylaxis in bipolar patients

J Affect Disord. 1999 Oct;55(2-3):133-42. doi: 10.1016/s0165-0327(98)00216-x.

Abstract

Background: This study aimed to investigate the demographical and clinical factors and their predictive powers before and at the end of the 6th and 12th month of lithium prophylaxis.

Methods: Subjects meeting the following criteria were included in the investigation: (1) bipolar patients (DSM-IV); (2) having at least a 3-year lithium prophylaxis; (3) being in either the 'definite poor' or 'definite good' response groups. Both groups were compared regarding sociodemographic and clinical variables.

Results: At the pretreatment point of the prophylaxis, four variables that could predict poor response with 74.1% power were severe episodes, higher ratio of mania/depression, psychotic index episode and being unmarried. At the end of the 6th month, the five variables having 84.89% predictive power for poor response were again the previous three variables and additionally bipolar I diagnosis and poor response to the first 6 months of lithium. At the end of the 12th month, the three variables for poor response had 91.37% predictive power and these were again the previous first two variables and a poor response to the first 12 months of lithium.

Limitations: This was a retrospective study; psychosocial stress was not evaluated by standardized criteria; and the predictive value of personality disorders could not be tested thoroughly.

Conclusions: This study suggests that it is possible to predict, rather reliably, the response to prophylactic lithium regarding clinical variables.

MeSH terms

  • Adult
  • Antimanic Agents / therapeutic use*
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / prevention & control*
  • Demography
  • Female
  • Humans
  • Lithium Carbonate / therapeutic use*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Stress, Psychological

Substances

  • Antimanic Agents
  • Lithium Carbonate