OBJECTIVE: The staging model suggests that early stages of bipolar disorder respond better to treatments and have a more favourable prognosis. This study aims to provide empirical support for the model, and the allied construct of early intervention. METHODS: Pooled data from mania, depression, and maintenance studies of olanzapine were analyzed. Individuals were categorized as having had 0, 1-5, 6-10, or >10 prior episodes of illness, and data were analyzed across these groups. RESULTS:Response rates for the mania and maintenance studies ranged from 52-69% and 10-50%, respectively, for individuals with 1-5 previous episodes, and from 29-59% and 11-40% for individuals with >5 previous episodes. These rates were significantly higher for the 1-5 group on most measures of response with up to a twofold increase in the chance of responding for those with fewer previous episodes. For the depression studies, response rates were significantly higher for the 1-5 group for two measures only. In the maintenance studies, the chance of relapse to either mania or depression was reduced by 40-60% for those who had experienced 1-5 episodes or 6-10 episodes compared to the >10 episode group, respectively. This trend was statistically significant only for relapse into mania for the 1-5 episode group (p=0.005). CONCLUSION: Those individuals at the earliest stages of illness consistently had a more favourable response to treatment. This is consistent with the staging model and underscores the need to support a policy of early intervention.
RCT Entities:
OBJECTIVE: The staging model suggests that early stages of bipolar disorder respond better to treatments and have a more favourable prognosis. This study aims to provide empirical support for the model, and the allied construct of early intervention. METHODS: Pooled data from mania, depression, and maintenance studies of olanzapine were analyzed. Individuals were categorized as having had 0, 1-5, 6-10, or >10 prior episodes of illness, and data were analyzed across these groups. RESULTS: Response rates for the mania and maintenance studies ranged from 52-69% and 10-50%, respectively, for individuals with 1-5 previous episodes, and from 29-59% and 11-40% for individuals with >5 previous episodes. These rates were significantly higher for the 1-5 group on most measures of response with up to a twofold increase in the chance of responding for those with fewer previous episodes. For the depression studies, response rates were significantly higher for the 1-5 group for two measures only. In the maintenance studies, the chance of relapse to either mania or depression was reduced by 40-60% for those who had experienced 1-5 episodes or 6-10 episodes compared to the >10 episode group, respectively. This trend was statistically significant only for relapse into mania for the 1-5 episode group (p=0.005). CONCLUSION: Those individuals at the earliest stages of illness consistently had a more favourable response to treatment. This is consistent with the staging model and underscores the need to support a policy of early intervention.
Authors: Michael Berk; Lesley Berk; Seetal Dodd; Sue Cotton; Craig Macneil; Rothanthi Daglas; Philippe Conus; Andreas Bechdolf; Steven Moylan; Gin S Malhi Journal: Bipolar Disord Date: 2013-06-20 Impact factor: 6.744
Authors: A Peters; L G Sylvia; P V da Silva Magalhães; D J Miklowitz; E Frank; M W Otto; N S Hansen; D D Dougherty; M Berk; A A Nierenberg; T Deckersbach Journal: Psychol Med Date: 2014-04-10 Impact factor: 7.723
Authors: Tomas Hajek; Katja Franke; Marian Kolenic; Jana Capkova; Martin Matejka; Lukas Propper; Rudolf Uher; Pavla Stopkova; Tomas Novak; Tomas Paus; Miloslav Kopecek; Filip Spaniel; Martin Alda Journal: Schizophr Bull Date: 2019-01-01 Impact factor: 9.306
Authors: Ann K Shinn; Kirsten W Bolton; Rakesh Karmacharya; Kathryn E Lewandowski; Cagri Yuksel; Justin T Baker; Virginie-Anne Chouinard; Samira M Pingali; Hilary Bye; Katherine Cederbaum; Dost Öngür Journal: Early Interv Psychiatry Date: 2015-11-29 Impact factor: 2.732