Does prophylaxis-delay in bipolar disorder influence outcome?: Results from a long-term study of 147 patients

被引:44
作者
Baethge, C
Smolka, MN
Gruschka, P
Berghöfer, A
Schlattmann, P
Bauer, M
Altshuler, L
Grof, P
Müller-Oerlinghausen, B
机构
[1] Free Univ Berlin, Klin Psychiat & Psychotherapie, D-14050 Berlin, Germany
[2] Cent Inst Mental Hlth, Dept Addict Behav & Addict Med, D-6800 Mannheim, Germany
[3] Heidelberg Univ, Dept Psychiat, Heidelberg, Germany
[4] Humboldt Univ, Charite, Inst Social Med Epidemiol & Hlth Econ, Berlin, Germany
[5] Humboldt Univ, Charite, Dept Psychiat & Psychotherapy, Berlin, Germany
[6] Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Behav Sci, Los Angeles, CA USA
[7] Univ Ottawa, Dept Psychiat, Ottawa, ON K1N 6N5, Canada
[8] German Med Assoc, Drug Commiss, Berlin, Germany
[9] Free Univ Berlin, Inst Med Informat Epidemiol & Biometrie, D-1000 Berlin, Germany
关键词
bipolar disorder; prophylaxis; lithium; carbamazepine; outcome; course; kindling;
D O I
10.1034/j.1600-0447.2003.02057.x
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: This study investigated the impact of latency (the time between illness onset and initiation of prophylactic treatment) on the outcome of prophylaxis in bipolar disorders. Method: The effect of prophylaxis delay (latency) on the course of illness was assessed in 147 patients. Dependent variables were: reduction of days spent in the hospital (prior to vs. during prophylaxis), time to first recurrence, and Morbidity-Index during prophylaxis (lithium or carbamazepine). Latency and other independent variables were tested using a multivariate approach. Results: Latency (9.3 years on average) had no significant effect on the subsequent response. Illness severity prior to prophylaxis, however, did predict the relative response. The course of illness during treatment could not be predicted by any one factor. Conclusion: The delay in initiating prophylaxis appears to have no influence on prophylaxis outcome. Instead, those whose illness was more severe were treated earlier and these patients subsequently showed a relatively greater response. If severity is not controlled for as part of the analysis, latency may be mistaken as an important predictor for response.
引用
收藏
页码:260 / 267
页数:8
相关论文
共 31 条
[1]   WHO RESPONDS TO PROPHYLACTIC LITHIUM-THERAPY [J].
ABOUSALEH, MT .
BRITISH JOURNAL OF PSYCHIATRY, 1993, 163 :20-26
[2]  
Baldessarini R J, 1999, Bipolar Disord, V1, P91, DOI 10.1034/j.1399-5618.1999.010206.x
[3]  
Baldessarini RJ, 1999, AM J PSYCHIAT, V156, P811
[4]  
BECH P, 1988, ACTA PSYCHIAT SCAND, V78, P45
[5]   Course of illness and pattern of recurrences in patients with affective disorders during long-term lithium prophylaxis: A retrospective analysis over 15 years [J].
Berghofer, A ;
Kossmann, B ;
MullerOerlinghausen, B .
ACTA PSYCHIATRICA SCANDINAVICA, 1996, 93 (05) :349-354
[6]   Predictors of response to mood stabilizers [J].
Calabrese, JR ;
Fatemi, H ;
Kujawa, M ;
Woyshville, MJ .
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 1996, 16 (02) :S24-S31
[7]   PLASMA FOLATE AND AFFECTIVE MORBIDITY DURING LONG-TERM LITHIUM-THERAPY [J].
COPPEN, A ;
ABOUSALEH, MT .
BRITISH JOURNAL OF PSYCHIATRY, 1982, 141 (JUL) :87-89
[8]   Bipolar I affective disorder: predictors of outcome after 15 years [J].
Coryell, W ;
Turvey, C ;
Endicott, J ;
Leon, AC ;
Mueller, T ;
Solomon, D ;
Keller, M .
JOURNAL OF AFFECTIVE DISORDERS, 1998, 50 (2-3) :109-116
[9]  
Coryell W., 1992, HDB AFFECTIVE DISORD, P89
[10]   RELIABILITY AND RELATIONSHIP OF VARIOUS AGES OF ONSET CRITERIA FOR MAJOR AFFECTIVE-DISORDER [J].
EGELAND, JA ;
BLUMENTHAL, RL ;
NEE, J ;
SHARPE, L ;
ENDICOTT, J .
JOURNAL OF AFFECTIVE DISORDERS, 1987, 12 (02) :159-165