Department of Clinical Psychology, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, India.
Asian J Psychiatr. 2019 Jan;39:165-168. doi: 10.1016/j.ajp.2018.04.006. Epub 2018 Apr 3.
Bipolar Disorder (BD) is a chronic and disabling psychiatric illness with waxing and waning course. Lithium is the mainstay of treatment for Bipolar disorder (BD). There is limited literature on the clinical markers of Lithium treatment response from south Asia.
Two hundred and ten individuals with BD I and a history of at least 6 months of treatment with Lithium were recruited from the outpatient services of the National Institute of Mental Health and Neurosciences (NIMHANS) after obtaining informed consent. A diagnosis of BD I was made according to the DSM-IV criteria. The characterization of response to lithium prophylaxis was done using NIMH Retrospective Life Chart and "Retrospective Criteria of Long Term Treatment Response in Research Subjects with Bipolar Disorder" scale.
There were 132 (62.86%) good responders and 78 (37.14%) non-responders. Good responders were noted to have less number of hospitalizations and more onset episode of depression than non-responders. Using continuous phenotype, Lithium response was inversely correlated with total number of episodes, number of episodes of mania/ depression, number of hospitalisations and presence of suicide attempt. Multivariate analysis only revealed number of episodes and hospitalization to be associated with Lithium response.
Our Lithium response rates were higher than what have been reported in the few previous studies. Illness severity was the only factor associated with Lithium response. There is a need to examine this question in larger prospective samples and to focus on biological/ molecular markers of treatment response.
双相情感障碍（BD）是一种慢性且致残的精神疾病，其病程时好时坏。锂盐是治疗双相情感障碍（BD）的主要药物。南亚地区关于锂盐治疗反应的临床标志物的文献有限。
在获得知情同意后，从国家心理健康和神经科学研究所（NIMHANS）的门诊服务中招募了 210 名患有 BD I 且至少有 6 个月锂盐治疗史的个体。根据 DSM-IV 标准诊断为 BD I。使用 NIMH 回顾性生命图表和“双相情感障碍研究对象长期治疗反应回顾性标准”量表对锂盐预防的反应特征进行了描述。
有 132 名（62.86%）为良好反应者，78 名（37.14%）为无反应者。良好反应者的住院次数较少，抑郁发作次数较多。使用连续表型，锂盐反应与总发作次数、躁狂/抑郁发作次数、住院次数和自杀企图的存在呈负相关。多变量分析仅显示发作次数和住院次数与锂盐反应相关。
我们的锂盐反应率高于以往少数研究报告的反应率。疾病严重程度是与锂盐反应唯一相关的因素。需要在更大的前瞻性样本中检查这个问题，并关注治疗反应的生物学/分子标志物。
