Lithium treatment versus hospitalization in bipolar disorder and major depression patients.
Bipolar disorder
Hospitalization
Lithium
Major depressive disorder
Morbidity
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 11 2023
01 11 2023
Historique:
received:
11
02
2023
revised:
24
07
2023
accepted:
03
08
2023
medline:
11
9
2023
pubmed:
10
8
2023
entrez:
9
8
2023
Statut:
ppublish
Résumé
Preventing hospitalization of major affective disorder patients is a fundamental clinical challenge for which lithium is expected to be helpful. We compared hospitalization rates and morbidity of 260 patients with DSM-5 bipolar or major depressive disorder in the 12 months before starting lithium versus 12 months of its use. We evaluated duration of untreated illness, previous treatments, substance abuse, suicidal status, lithium dose, and use of other medicines for association with new episodes of illness or of symptomatic worsening as well as hospitalization, using bivariate and multivariate analyses. Within 12 months before lithium, 40.4 % of patients were hospitalized versus 11.2 % during lithium treatment; other measures of morbidity also improved. Benefits were similar with bipolar and major depressive disorders. Independently associated with hospitalization during lithium treatment were: receiving an antipsychotic with lithium, suicide attempt during lithium treatment, lifetime substance abuse, and psychiatric hospitalization in the year before starting lithium, but not diagnosis. Participants and observation times were limited. The study was retrospective regarding clinical history, lacked strict control of treatments and was not blinded. This naturalistic study adds support to the effectiveness of lithium treatment in preventing hospitalization in patients with episodic major mood disorders.
Sections du résumé
BACKGROUND
Preventing hospitalization of major affective disorder patients is a fundamental clinical challenge for which lithium is expected to be helpful.
METHODS
We compared hospitalization rates and morbidity of 260 patients with DSM-5 bipolar or major depressive disorder in the 12 months before starting lithium versus 12 months of its use. We evaluated duration of untreated illness, previous treatments, substance abuse, suicidal status, lithium dose, and use of other medicines for association with new episodes of illness or of symptomatic worsening as well as hospitalization, using bivariate and multivariate analyses.
RESULTS
Within 12 months before lithium, 40.4 % of patients were hospitalized versus 11.2 % during lithium treatment; other measures of morbidity also improved. Benefits were similar with bipolar and major depressive disorders. Independently associated with hospitalization during lithium treatment were: receiving an antipsychotic with lithium, suicide attempt during lithium treatment, lifetime substance abuse, and psychiatric hospitalization in the year before starting lithium, but not diagnosis.
LIMITATIONS
Participants and observation times were limited. The study was retrospective regarding clinical history, lacked strict control of treatments and was not blinded.
CONCLUSIONS
This naturalistic study adds support to the effectiveness of lithium treatment in preventing hospitalization in patients with episodic major mood disorders.
Identifiants
pubmed: 37557990
pii: S0165-0327(23)01004-2
doi: 10.1016/j.jad.2023.08.028
pii:
doi:
Substances chimiques
Lithium
9FN79X2M3F
Lithium Compounds
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
245-249Informations de copyright
Copyright © 2023 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest All authors and immediate family members declare no apparent or potential conflicts of interest in the material presented arising from financial relationships with commercial organizations. In the last two years, MP has received lecture or advisory board honoraria or engaged in clinical trial activities with Angelini Pharma, Lundbeck, Janssen, Pfizer, MSD, Rovi, Fidia and Recordati Corporations.