Clinical course and need for hospital admission after lithium discontinuation in patients with bipolar disorder type I or II : mirror-image study based on the LiSIE retrospective cohort
| Autor: | Sofia Oja, Louise Öhlund, Michael Ott, Mikael Sandlund, Malin Bergqvist, Ursula Werneke, Ellinor Salander Renberg, Robert Lundqvist |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty Lithium (medication) Bipolar disorder mood stabiliser Image Study Psykiatri 03 medical and health sciences 0302 clinical medicine Medicine In patient Psychiatry business.industry hospitalisation Clinical course Retrospective cohort study medicine.disease 030227 psychiatry Discontinuation Psychiatry and Mental health lithium admission Papers Hospital admission business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BJPsych Open |
| ISSN: | 2056-4724 |
| Popis: | Background Currently, the evidence for lithium as a maintenance treatment for bipolar disorder type II (BD-II) remains limited. Guidelines commonly extrapolate recommendations for BD-II from available evidence for bipolar disorder type I (BD-I). Comparing the impact of lithium discontinuation is one way of assessing effectiveness in both groups. Aims To compare the impact of lithium discontinuation on hospital admissions and self-harm in patients with BD-I or schizoaffective disorder (SZD) and patients with BD-II or other bipolar disorder. Method Mirror-image study, examining hospital admissions within 2 years before and after lithium discontinuation in both patient groups. This study was part of a retrospective cohort study (LiSIE) into effects and side-effects of lithium for maintenance treatment of bipolar disorder as compared with other mood stabilisers. Results For the whole sample, the mean number of admissions/patient/review period doubled from 0.44 to 0.95 (PP = 0.025). This increase in admissions and bed days was exclusively attributable to patients with BD-I/SZD. Not having consulted with a doctor prior to lithium discontinuation or no treatment with an alternative mood stabiliser at the time of lithium discontinuation led to more admissions. Conclusions The higher relapse risk in patients with BD-I/SZD suggests a higher threshold for discontinuing lithium than for patients with BD-II/other bipolar disorder. In patients with BD-II/other bipolar disorder, however, judged on the impact of discontinuation alone, lithium did not appear to prevent more severe depressive episodes requiring hospital admission. |
| Databáze: | OpenAIRE |
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