OBJECTIVES: There is still debate about whether the quality of long-term efficacy of lithium in patients with bipolar disorders is influenced by atypical features. Extended Cox regression models allow for the use of all follow-up data on diseases with multiple episodes. The aim of the present analysis was to apply the best suited of these models to analyze the influence of atypical features on the widely used outcome measure of time to recurrence in a large multicenter cohort of lithium responders established by the International Group for the Study of Lithium Treated Patients. METHODS: A conditional extended Cox model with a random frailty term was applied to the data of 336 bipolar I and II disorder patients, all of whom were responders to lithium with treatment for up to 30 years. RESULTS: Differences were found in the long-term outcome, even in patients who have demonstrated a relatively good response to lithium treatment. The hazard for recurrence was negatively influenced by the presence of atypical features, mainly mood-incongruent psychotic symptoms, interepisodic residual symptomatology, and rapid cycling. CONCLUSIONS: As a result of the findings, physicians should regularly reassess the quality of response in bipolar disorder patients with atypical features and, if necessary, modify treatment. Extended Cox regression models are well suited for evaluating long-term outcome and should be used more extensively to analyze treatment outcome in psychiatric and somatic disorders.
OBJECTIVES: There is still debate about whether the quality of long-term efficacy of lithium in patients with bipolar disorders is influenced by atypical features. Extended Cox regression models allow for the use of all follow-up data on diseases with multiple episodes. The aim of the present analysis was to apply the best suited of these models to analyze the influence of atypical features on the widely used outcome measure of time to recurrence in a large multicenter cohort of lithium responders established by the International Group for the Study of Lithium Treated Patients. METHODS: A conditional extended Cox model with a random frailty term was applied to the data of 336 bipolar I and II disorderpatients, all of whom were responders to lithium with treatment for up to 30 years. RESULTS: Differences were found in the long-term outcome, even in patients who have demonstrated a relatively good response to lithium treatment. The hazard for recurrence was negatively influenced by the presence of atypical features, mainly mood-incongruent psychotic symptoms, interepisodic residual symptomatology, and rapid cycling. CONCLUSIONS: As a result of the findings, physicians should regularly reassess the quality of response in bipolar disorderpatients with atypical features and, if necessary, modify treatment. Extended Cox regression models are well suited for evaluating long-term outcome and should be used more extensively to analyze treatment outcome in psychiatric and somatic disorders.
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: F S Goes; M L Hamshere; F Seifuddin; M Pirooznia; P Belmonte-Mahon; R Breuer; T Schulze; M Nöthen; S Cichon; M Rietschel; P Holmans; P P Zandi; N Craddock; J B Potash Journal: Transl Psychiatry Date: 2012-10-23 Impact factor: 6.222
Authors: Azmeraw T Amare; Klaus Oliver Schubert; Liping Hou; Scott R Clark; Sergi Papiol; Micah Cearns; Urs Heilbronner; Franziska Degenhardt; Fasil Tekola-Ayele; Yi-Hsiang Hsu; Tatyana Shekhtman; Mazda Adli; Nirmala Akula; Kazufumi Akiyama; Raffaella Ardau; Bárbara Arias; Jean-Michel Aubry; Lena Backlund; Abesh Kumar Bhattacharjee; Frank Bellivier; Antonio Benabarre; Susanne Bengesser; Joanna M Biernacka; Armin Birner; Clara Brichant-Petitjean; Pablo Cervantes; Hsi-Chung Chen; Caterina Chillotti; Sven Cichon; Cristiana Cruceanu; Piotr M Czerski; Nina Dalkner; Alexandre Dayer; Maria Del Zompo; J Raymond DePaulo; Bruno Étain; Stephane Jamain; Peter Falkai; Andreas J Forstner; Louise Frisen; Mark A Frye; Janice M Fullerton; Sébastien Gard; Julie S Garnham; Fernando S Goes; Maria Grigoroiu-Serbanescu; Paul Grof; Ryota Hashimoto; Joanna Hauser; Stefan Herms; Per Hoffmann; Andrea Hofmann; Esther Jiménez; Jean-Pierre Kahn; Layla Kassem; Po-Hsiu Kuo; Tadafumi Kato; John R Kelsoe; Sarah Kittel-Schneider; Sebastian Kliwicki; Barbara König; Ichiro Kusumi; Gonzalo Laje; Mikael Landén; Catharina Lavebratt; Marion Leboyer; Susan G Leckband; Alfonso Tortorella; Mirko Manchia; Lina Martinsson; Michael J McCarthy; Susan L McElroy; Francesc Colom; Marina Mitjans; Francis M Mondimore; Palmiero Monteleone; Caroline M Nievergelt; Markus M Nöthen; Tomas Novák; Claire O'Donovan; Norio Ozaki; Urban Ösby; Andrea Pfennig; James B Potash; Andreas Reif; Eva Reininghaus; Guy A Rouleau; Janusz K Rybakowski; Martin Schalling; Peter R Schofield; Barbara W Schweizer; Giovanni Severino; Paul D Shilling; Katzutaka Shimoda; Christian Simhandl; Claire M Slaney; Alessio Squassina; Thomas Stamm; Pavla Stopkova; Mario Maj; Gustavo Turecki; Eduard Vieta; Julia Veeh; Stephanie H Witt; Adam Wright; Peter P Zandi; Philip B Mitchell; Michael Bauer; Martin Alda; Marcella Rietschel; Francis J McMahon; Thomas G Schulze; Bernhard T Baune Journal: Mol Psychiatry Date: 2020-03-16 Impact factor: 13.437