Antonio Tundo1, Franco De Crescenzo2, Davide Gori3, Paola Cavalieri4. 1. Istituto di Psicopatologia, via Girolamo da Carpi, 1, Rome, Italy. Electronic address: tundo@istitutodipsicopatologia.it. 2. Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A.Gemelli", Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome 00168, Italy. 3. Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum, Università di Bologna, Italy. 4. Istituto di Psicopatologia, via Girolamo da Carpi, 1, Rome, Italy.
Abstract
OBJECTIVE: About 30% of patients with bipolar disorders (BD) exhibit a continuous cycling course (CCC). These patients significantly differ from those with non-continuous cycling course (NCCC) on clinical presentation and have a poorer short-term response to antidepressant treatment. Our aim is to conduct a meta-analysis of the studies comparing long-term treatment response in CCC and NCCC bipolar patients. METHOD: We conducted a systematic review of studies on patients with a diagnosis of bipolar disorder with CCC. Our primary outcome measure was the response to treatment at the last follow-up visit. The data analysis was based on the success rate difference as the effect size measure. To account for heterogeneity of primary studies, aggregation of results was based on a random-effects model. RESULTS: We included six observational studies comprising a total of 671 patients (CCC 29.4%, NCCC 70.6%). Overall, the response rate was 34.0% in the CCC and 49.3% in the NCCC arm. The meta-analysis shows a significant association between cycle pattern and response (success rate difference: -0.17; 95% CI: -0.25, -0.09; p < 0.0001), with low heterogeneity (χ2 (5 )= 5.16; I2 = 3%). CONCLUSION: In bipolar disorders, patients with CCC have a poorer response to prophylactic treatment compared with patients with NCCC.
OBJECTIVE: About 30% of patients with bipolar disorders (BD) exhibit a continuous cycling course (CCC). These patients significantly differ from those with non-continuous cycling course (NCCC) on clinical presentation and have a poorer short-term response to antidepressant treatment. Our aim is to conduct a meta-analysis of the studies comparing long-term treatment response in CCC and NCCC bipolarpatients. METHOD: We conducted a systematic review of studies on patients with a diagnosis of bipolar disorder with CCC. Our primary outcome measure was the response to treatment at the last follow-up visit. The data analysis was based on the success rate difference as the effect size measure. To account for heterogeneity of primary studies, aggregation of results was based on a random-effects model. RESULTS: We included six observational studies comprising a total of 671 patients (CCC 29.4%, NCCC 70.6%). Overall, the response rate was 34.0% in the CCC and 49.3% in the NCCC arm. The meta-analysis shows a significant association between cycle pattern and response (success rate difference: -0.17; 95% CI: -0.25, -0.09; p < 0.0001), with low heterogeneity (χ2 (5 )= 5.16; I2 = 3%). CONCLUSION: In bipolar disorders, patients with CCC have a poorer response to prophylactic treatment compared with patients with NCCC.
Authors: Romain Icick; Ingrid Melle; Bruno Etain; Margrethe Collier Høegh; Sébastien Gard; Sofie R Aminoff; Marion Leboyer; Ole A Andreassen; Raoul Belzeaux; Chantal Henry; Thomas D Bjella; Jean-Pierre Kahn; Nils Eiel Steen; Frank Bellivier; Trine Vik Lagerberg Journal: Front Psychiatry Date: 2022-05-03 Impact factor: 5.435
Authors: Andrew A Nierenberg; Meredith G Harris; Alan E Kazdin; Victor Puac-Polanco; Nancy Sampson; Daniel V Vigo; Wai Tat Chiu; Hannah N Ziobrowski; Jordi Alonso; Yasmin Altwaijri; Guilherme Borges; Brendan Bunting; José Miguel Caldas-de-Almeida; Josep Maria Haro; Chi-Yi Hu; Andrzej Kiejna; Sing Lee; John J McGrath; Fernando Navarro-Mateu; José Posada-Villa; Kate M Scott; Juan C Stagnaro; Maria C Viana; Ronald C Kessler Journal: Bipolar Disord Date: 2021-03-28 Impact factor: 5.345