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Outcome of Bipolar Disorder on Long-Term Treatment with Lithium

Published online by Cambridge University Press:  02 January 2018

Ralph A. O'Connell ,
Julia A. Mayo ,
Leslie Flatow ,
Beverly Cuthbertson  and
Barbara E. O'Brien
Ralph A. O'Connell*
Affiliation:
St Vincent's Hospital and Medical Center, New York Medical College
Julia A. Mayo
Affiliation:
Clinical Studies, Clinical Associate Professor of Psychiatry
Leslie Flatow
Affiliation:
Preventive Treatment Program
Beverly Cuthbertson
Affiliation:
Chief Outpatient Service
Barbara E. O'Brien
Affiliation:
Chief Outpatient Service
*
∗Department of Psychiatry, St Vincent's Hospital, 153 West 11th Street, New York, NY 10011, USA
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Abstract

The long-term treatment outcome of 248 bipolar patients in an out-patient lithium programme was assessed. Over half of the patients (138 or 56%) had no affective episodes in the year observed. Patients were divided into outcome groups according to GAS scores: the outcome for 40% of patients was good, for 41% fair, and for 19% poor. More frequent psychiatric admissions before starting lithium treatment was the best predictor of poor outcome, followed by a negative affective style in the family and lower social class. Current alcohol and drug abuse was associated with poor outcome. Although familial and psychosocial factors were significantly associated with outcome, the findings suggest there may be inherent differences in the pathophysiology of bipolar disorder reflected in an increased frequency of episodes which account for a large variance in lithium treatment outcome.

Type
Papers
Information
The British Journal of Psychiatry , Volume 159 , Issue 1 , July 1991 , pp. 123 - 129
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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