Diane Grillault Laroche1,2, Bruno Etain3,4,5,6, Emanuel Severus7, Jan Scott8,9,10, Frank Bellivier1,2,8. 1. INSERM U1144 - Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris Descartes, Paris, France. 2. AP-HP, DMU Neurosciences, GH Saint-Louis - Lariboisière - F. Widal, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France. 3. INSERM U1144 - Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris Descartes, Paris, France. bruno.etain@inserm.fr. 4. AP-HP, DMU Neurosciences, GH Saint-Louis - Lariboisière - F. Widal, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France. bruno.etain@inserm.fr. 5. Faculté de Médecine, Université de Paris, Paris, France. bruno.etain@inserm.fr. 6. Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neurosciences, London, UK. bruno.etain@inserm.fr. 7. Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany. 8. Faculté de Médecine, Université de Paris, Paris, France. 9. Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neurosciences, London, UK. 10. Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK.
Abstract
OBJECTIVE: To identify possible socio-demographic and clinical factors associated with Good Outcome (GO) as compared with Poor Outcome (PO) in adult patients diagnosed with Bipolar Disorder (BD) who received long-term treatment with lithium. METHODS: A comprehensive search of major electronic databases was performed to identify relevant studies that included adults patients (18 years or older) with a diagnosis of BD and reported sociodemographic and/or clinical variables associated with treatment response and/or with illness outcome during long-term treatment to lithium (> = 6 months). The quality of the studies was scored using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Institute of Health. RESULTS: Following review, 34 publications (from 31 independent datasets) were eligible for inclusion in this review. Most of them (n = 25) used a retrospective design. Only 11 studies were graded as good or borderline good quality. Forty-three potential predictors of outcome to lithium were identified. Four factors were associated with PO to lithium: alcohol use disorder; personality disorders; higher lifetime number of hospital admissions and rapid cycling pattern. Two factors were associated with GO in patients treated with lithium: good social support and episodic evolution of BD. However, when the synthesis of findings was limited to the highest (good or borderline good) quality studies (11 studies), only higher lifetime number of hospitalization admissions remained associated with PO to lithium and no associations remained for GO to lithium. CONCLUSION: Despite decades of research on lithium and its clinical use, besides lifetime number of hospital admissions, no factor being consistently associated with GO or PO to lithium was identified. Hence, there remains a substantial gap in our understanding of predictors of outcome of lithium treatment indicating there is a need of high quality research on large representative samples.
OBJECTIVE: To identify possible socio-demographic and clinical factors associated with Good Outcome (GO) as compared with Poor Outcome (PO) in adult patients diagnosed with Bipolar Disorder (BD) who received long-term treatment with lithium. METHODS: A comprehensive search of major electronic databases was performed to identify relevant studies that included adults patients (18 years or older) with a diagnosis of BD and reported sociodemographic and/or clinical variables associated with treatment response and/or with illness outcome during long-term treatment to lithium (> = 6 months). The quality of the studies was scored using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Institute of Health. RESULTS: Following review, 34 publications (from 31 independent datasets) were eligible for inclusion in this review. Most of them (n = 25) used a retrospective design. Only 11 studies were graded as good or borderline good quality. Forty-three potential predictors of outcome to lithium were identified. Four factors were associated with PO to lithium: alcohol use disorder; personality disorders; higher lifetime number of hospital admissions and rapid cycling pattern. Two factors were associated with GO in patients treated with lithium: good social support and episodic evolution of BD. However, when the synthesis of findings was limited to the highest (good or borderline good) quality studies (11 studies), only higher lifetime number of hospitalization admissions remained associated with PO to lithium and no associations remained for GO to lithium. CONCLUSION: Despite decades of research on lithium and its clinical use, besides lifetime number of hospital admissions, no factor being consistently associated with GO or PO to lithium was identified. Hence, there remains a substantial gap in our understanding of predictors of outcome of lithium treatment indicating there is a need of high quality research on large representative samples.
Authors: Pamela Y Collins; Vikram Patel; Sarah S Joestl; Dana March; Thomas R Insel; Abdallah S Daar; Warwick Anderson; Muhammad A Dhansay; Anthony Phillips; Susan Shurin; Mark Walport; Wendy Ewart; Sir John Savill; Isabel A Bordin; E Jane Costello; Maureen Durkin; Christopher Fairburn; Roger I Glass; Wayne Hall; Yueqin Huang; Steven E Hyman; Kay Jamison; Sylvia Kaaya; Shitij Kapur; Arthur Kleinman; Adesola Ogunniyi; Angel Otero-Ojeda; Mu-Ming Poo; Vijayalakshmi Ravindranath; Barbara J Sahakian; Shekhar Saxena; Peter A Singer; Dan J Stein Journal: Nature Date: 2011-07-06 Impact factor: 49.962
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Authors: G M Goodwin; P M Haddad; I N Ferrier; J K Aronson; Trh Barnes; A Cipriani; D R Coghill; S Fazel; J R Geddes; H Grunze; E A Holmes; O Howes; S Hudson; N Hunt; I Jones; I C Macmillan; H McAllister-Williams; D R Miklowitz; R Morriss; M Munafò; C Paton; B J Saharkian; Kea Saunders; Jma Sinclair; D Taylor; E Vieta; A H Young Journal: J Psychopharmacol Date: 2016-03-15 Impact factor: 4.153