Lena Backlund1, Anna Ehnvall, Jerker Hetta, Göran Isacsson, Hans Agren. 1. Karolinska Institute, Department of Clinical Neuroscience, Section of Psychiatry, Karolinska University Hospital, Huddinge M57, SE-141 86 Stockholm, Sweden. lena.m.backlund@sll.se
Abstract
PURPOSE: Our aim was to investigate bipolar patients in order to test the validity of various outcome measures and to identify prognostic predictors for pharmacological treatment. MATERIAL AND METHOD: One hundred patients were interviewed using a computerized life-charting program in a descriptive, retrospective analysis. The concept "Burden of illness" was defined as a combination of severity and duration of episodes. Response to treatment was defined as the difference in burden before and after treatment, a low burden during treatment, and freedom of episodes for at least 3 years after insertion of treatment. RESULTS: The absence of mixed episodes and a high initial burden predicted a good response measured as the difference in burden. If remission for 3 years or a low burden during lithium treatment was used, the absence of rapid cycling and of mixed episodes were the most important predictors. The severity of illness before treatment had no impact. DISCUSSION AND CONCLUSION: We suggest the use of absolute measures of severity during treatment as the most appropriate measure of the outcome. Furthermore, our data provide corroboration that treatment with lithium ameliorates the prognosis of the illness, but that mixed episodes and rapid cycling predict a poorer response to lithium.
PURPOSE: Our aim was to investigate bipolarpatients in order to test the validity of various outcome measures and to identify prognostic predictors for pharmacological treatment. MATERIAL AND METHOD: One hundred patients were interviewed using a computerized life-charting program in a descriptive, retrospective analysis. The concept "Burden of illness" was defined as a combination of severity and duration of episodes. Response to treatment was defined as the difference in burden before and after treatment, a low burden during treatment, and freedom of episodes for at least 3 years after insertion of treatment. RESULTS: The absence of mixed episodes and a high initial burden predicted a good response measured as the difference in burden. If remission for 3 years or a low burden during lithium treatment was used, the absence of rapid cycling and of mixed episodes were the most important predictors. The severity of illness before treatment had no impact. DISCUSSION AND CONCLUSION: We suggest the use of absolute measures of severity during treatment as the most appropriate measure of the outcome. Furthermore, our data provide corroboration that treatment with lithium ameliorates the prognosis of the illness, but that mixed episodes and rapid cycling predict a poorer response to lithium.
Authors: Anne Berghöfer; Martin Alda; Mazda Adli; Christopher Baethge; Michael Bauer; Tom Bschor; Paul Grof; Bruno Müller-Oerlinghausen; Janusz K Rybakowski; Alexandra Suwalska; Andrea Pfennig Journal: Int J Bipolar Disord Date: 2013-07-31
Authors: Abraham Nunes; William Stone; Raffaella Ardau; Anne Berghöfer; Alberto Bocchetta; Caterina Chillotti; Valeria Deiana; Franziska Degenhardt; Andreas J Forstner; Julie S Garnham; Eva Grof; Tomas Hajek; Mirko Manchia; Manuel Mattheisen; Francis McMahon; Bruno Müller-Oerlinghausen; Markus M Nöthen; Marco Pinna; Claudia Pisanu; Claire O'Donovan; Marcella D C Rietschel; Guy Rouleau; Thomas Schulze; Giovanni Severino; Claire M Slaney; Alessio Squassina; Aleksandra Suwalska; Gustavo Turecki; Rudolf Uher; Petr Zvolsky; Pablo Cervantes; Maria Del Zompo; Paul Grof; Janusz Rybakowski; Leonardo Tondo; Thomas Trappenberg; Martin Alda Journal: Transl Psychiatry Date: 2021-01-11 Impact factor: 6.222
Authors: L Martinsson; Y Wei; D Xu; P A Melas; A A Mathé; M Schalling; C Lavebratt; L Backlund Journal: Transl Psychiatry Date: 2013-05-21 Impact factor: 6.222