Hui, TP;
Kandola, A;
Shen, L;
Lewis, G;
Osborn, DPJ;
Geddes, J;
Hayes, JF;
(2019)
A systematic review and meta-analysis of clinical predictors of lithium response in bipolar disorder.
Acta Psychiatrica Scandinavica
10.1111/acps.13062.
(In press).
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Abstract
OBJECTIVE: To determine clinical predictors of lithium response in bipolar disorder. METHODS: Systematic review of studies examining clinical predictors of lithium response was conducted. Meta-analyses were performed when ≥2 studies examined the same potential predictor. RESULTS: A total of 71 studies, including over 12,000 patients, identified 6 predictors of good response: mania-depression-interval sequence (odds ratio (OR): 4.27; 95%CI: 2.61, 6.97; p<0.001), absence of rapid cycling (OR for rapid cycling: 0.30; 95%CI: 0.17, 0.53; p<0.001), absence of psychotic symptoms (OR for psychotic symptoms: 0.52; 95%CI: 0.34, 0.79; p=0.002), family history of bipolar disorder (OR: 1.61; 95%CI: 1.03, 2.52; p=0.036), shorter pre-lithium illness duration (standardized mean difference (SMD): -0.26; 95%CI: -0.41, -0.12; p<0.001), later age of onset (SMD: 0.17; 95%CI: 0.02, 0.36; p=0.029). Additionally, higher body mass index was associated with poor response in two studies (SMD: -0.61; 95%CI: -0.90, -0.32; p<0.001). There was weak evidence for number of episodes prior to lithium treatment (SMD: -0.42; 95%CI: -0.84, -0.01; p=0.046), number of hospitalisations before lithium (SMD: -0.40; 95%CI: -0.81, 0.01; p=0.055) and family history of lithium response (OR: 10.28.; 95%CI: 0.66, 161.26; p=0.097). CONCLUSIONS: The relative importance of these clinical characteristics should be interpreted with caution due to potential biases and confounding. This article is protected by copyright.
| Type: | Article |
|---|---|
| Title: | A systematic review and meta-analysis of clinical predictors of lithium response in bipolar disorder |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/acps.13062 |
| Publisher version: | https://doi.org/10.1111/acps.13062 |
| Language: | English |
| Additional information: | © 2019 The Authors Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | bipolar disorder, clinical aspects, lithium |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10077668 |
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