Clinicians' preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders around the world: a survey from the ISBD Lithium task force.

Attitudes Bipolar disorders Lithium Maintenance Preferences Survey Treatment Use

Journal

International journal of bipolar disorders
ISSN: 2194-7511
Titre abrégé: Int J Bipolar Disord
Pays: Germany
ID NLM: 101622983

Informations de publication

Date de publication:
27 May 2023
Historique:
received: 16 11 2022
accepted: 08 05 2023
medline: 27 5 2023
pubmed: 27 5 2023
entrez: 27 5 2023
Statut: epublish

Résumé

Lithium has long been considered the gold-standard pharmacological treatment for the maintenance treatment of bipolar disorders (BD) which is supported by a wide body of evidence. Prior research has shown a steady decline in lithium prescriptions during the last two decades. We aim to identify potential factors explaining this decline across the world with an anonymous worldwide survey developed by the International Society for Bipolar Disorders (ISBD) Task Force "Role of Lithium in Bipolar Disorders" and distributed by diverse academic and professional international channels. A total of 886 responses were received of which 606 completed the entire questionnaire while 206 completed it partially. Respondents were from 43 different countries comprising all continents. Lithium was the most preferred treatment option for the maintenance of BD patients (59%). The most relevant clinical circumstances in which lithium was the preferred option were in patients with BD I (53%), a family history of response (18%), and a prior response during acute treatment (17%). In contrast, Lithium was not the preferred option in case of patients´ negative beliefs and/or attitudes towards lithium (13%), acute side-effects or tolerability problems (10%) and intoxication risk (8%). Clinicians were less likely to prefer lithium as a first option in BD maintenance phase when practising in developing economy countries [X2 (1, N = 430) = 9465, p = 0.002) ] and private sectors [X2 (1, N = 434) = 8191, p = 0.004)]. Clinicians' preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders appear to be affected by both the patients' beliefs and the professional contexts where clinicians provide their services. More research involving patients is needed for identifying their attitudes toward lithium and factors affecting its use, particularly in developing economies.

Sections du résumé

BACKGROUND BACKGROUND
Lithium has long been considered the gold-standard pharmacological treatment for the maintenance treatment of bipolar disorders (BD) which is supported by a wide body of evidence. Prior research has shown a steady decline in lithium prescriptions during the last two decades. We aim to identify potential factors explaining this decline across the world with an anonymous worldwide survey developed by the International Society for Bipolar Disorders (ISBD) Task Force "Role of Lithium in Bipolar Disorders" and distributed by diverse academic and professional international channels.
RESULTS RESULTS
A total of 886 responses were received of which 606 completed the entire questionnaire while 206 completed it partially. Respondents were from 43 different countries comprising all continents. Lithium was the most preferred treatment option for the maintenance of BD patients (59%). The most relevant clinical circumstances in which lithium was the preferred option were in patients with BD I (53%), a family history of response (18%), and a prior response during acute treatment (17%). In contrast, Lithium was not the preferred option in case of patients´ negative beliefs and/or attitudes towards lithium (13%), acute side-effects or tolerability problems (10%) and intoxication risk (8%). Clinicians were less likely to prefer lithium as a first option in BD maintenance phase when practising in developing economy countries [X2 (1, N = 430) = 9465, p = 0.002) ] and private sectors [X2 (1, N = 434) = 8191, p = 0.004)].
CONCLUSIONS CONCLUSIONS
Clinicians' preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders appear to be affected by both the patients' beliefs and the professional contexts where clinicians provide their services. More research involving patients is needed for identifying their attitudes toward lithium and factors affecting its use, particularly in developing economies.

Identifiants

pubmed: 37243681
doi: 10.1186/s40345-023-00301-y
pii: 10.1186/s40345-023-00301-y
pmc: PMC10220344
doi:

Types de publication

Journal Article

Langues

eng

Pagination

20

Informations de copyright

© 2023. The Author(s).

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Auteurs

Diego Hidalgo-Mazzei (D)

Bipolar and depressive disorders unit, Department of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, University of Barcelona, 170 Villarroel St, 08036, Barcelona, Spain.
Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), C. Casanova, 143, 08036, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , King's College London, London, UK.

Tim Mantingh (T)

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , King's College London, London, UK.

Xavier Pérez de Mendiola (X)

Bioaraba, Psychiatry Service, Department of Neurosciences, Research Group on Severe Mental Illness, Araba University Hospital, University of the Basque Country UPV/EHU, Osakidetza, Vitoria-Gasteiz, Spain.

Ludovic Samalin (L)

Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France.

Juan Undurraga (J)

Department of Neurology and Psychiatry, Clinica Alemana Universidad Del Desarrollo, Santiago, Chile.

Sergio Strejilevich (S)

Área, Asistencia e investigación en trastornos del ánimo, Buenos Aires, Argentina.

Emanuel Severus (E)

Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.

Michael Bauer (M)

Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.

Ana González-Pinto (A)

Bioaraba, Psychiatry Service, Department of Neurosciences, Research Group on Severe Mental Illness, Araba University Hospital, University of the Basque Country UPV/EHU, Osakidetza, Vitoria-Gasteiz, Spain.

Willem A Nolen (WA)

Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Allan H Young (AH)

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience , King's College London, London, UK.

Eduard Vieta (E)

Bipolar and depressive disorders unit, Department of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, University of Barcelona, 170 Villarroel St, 08036, Barcelona, Spain. evieta@clinic.cat.
Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), C. Casanova, 143, 08036, Barcelona, Spain. evieta@clinic.cat.
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. evieta@clinic.cat.

Classifications MeSH