Clinical factors associated with lithium response in bipolar disorders - Archive ouverte HAL Access content directly
Journal Articles Australian and New Zealand Journal of Psychiatry Year : 2017

Clinical factors associated with lithium response in bipolar disorders

(1, 2, 3) , (1, 2, 3) , (1, 2, 3) , (3, 4) , (3, 5, 6) , (3, 7, 8) , (3, 9, 10) , (3, 9, 11) , (1, 2, 3) , (12, 13) , (1, 2, 3)
1
2
3
4
5
6
7
8
9
10
11
12
13

Abstract

Background: Bipolar disorder is a common chronic illness characterized by high levels of morbidity and all-cause mortality. Lithium is one of the gold standard mood stabilizer treatments, but the identification of good, partial and non-responders in clinical settings is inconsistent. Methods: We used an established rating scale (the Alda scale) to classify the degree of lithium response (good response, partial response, non-response) in a large, multicentre clinically representative sample of well-characterized cases of bipolar disorders I and II. Next, we examined previously reported clinical predictors of response to determine which factors significantly differentiated between the three response groups. Results: Of 754 cases, 300 received lithium, for at least 6 months, as a treatment for bipolar disorder (40%). Of these cases, 17% were classified as good response, 52% as partial response and 31% as non-response. Lifetime history of mixed episodes ( p = 0.017) and alcohol use disorders ( p = 0.015) both occurred in >20% of partial response and non-response groups but <10% of good response cases. Family history of bipolar disorder I was of borderline statistical significance, being more frequent in the good response group (38%) compared with the non-response group (18%). There was a trend ( p = 0.06) for bipolar disorder II to be associated with non-response. Conclusions: Only three factors previously identified as predictors of lithium response significantly differentiated the response groups identified in our sample. Interestingly, these factors have all been found to co-occur more often than expected by chance, and it can be hypothesized that they may represent a shared underlying factor or dimension. Further prospective studies of predictors and the performance of the Alda scale are recommended.

Dates and versions

inserm-03854484 , version 1 (15-11-2022)

Identifiers

Cite

Sarah Sportiche, Pierre Alexis Geoffroy, Clara Brichant-Petitjean, Sebastien Gard, Jean-Pierre Khan, et al.. Clinical factors associated with lithium response in bipolar disorders. Australian and New Zealand Journal of Psychiatry, 2017, 51 (5), pp.524-530. ⟨10.1177/0004867416664794⟩. ⟨inserm-03854484⟩
0 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More