Clinical predictors of long-term outcome of lithium prophylaxis in bipolar disorder

Abstract

Introduction: In spite of the frequent prophylactic use of lithium salts in affective disorders, few papers have been published about clinical outcome predictors in long-term follow-up.

Objective: To identify clinical predictors of long-term outcome in a sample of bipolar outpatients on lithium treatment.

Methods: An intervention study was conducted in a case series of all patients treated, at least for two years, at two Affective Disorders ambulatory Units. It was examined the association between two dependent outcome variables (presence vs absence of relapses and number of relapses/person/year) and the rest of clinical variables.

Results: 139 outpatients diagnosed of bipolar disorder were included in the sample. In each case, therapeutic lithium dosages were administered. Delay time to start treatment since the disorder has begun was the only variable useful to predict weakly outcome. The time spent without treatment and the association with other mood stabilizers or neuroleptics correlates with bad outcome.

Conclusion: Whichever clinical characteristics of the sample may be, patients should be treated as soon as possible with lithium to get better outcome.