Institute of Neuroscience, Newcastle University, Newcastle, UK.
Université Paris Diderot and INSERM UMRS1144, Paris, France.
Acta Psychiatr Scand. 2020 Jun;141(6):522-533. doi: 10.1111/acps.13163. Epub 2020 Mar 15.
To undertake a large-scale clinical study of predictors of lithium (Li) response in bipolar I disorder (BD-I) and apply contemporary multivariate approaches to account for inter-relationships between putative predictors.
We used network analysis to estimate the number and strength of connections between potential predictors of good Li response (measured by a new scoring algorithm for the Retrospective Assessment of Response to Lithium Scale) in 900 individuals with BD-I recruited to the Consortium of Lithium Genetics.
After accounting for co-associations between potential predictors, the most important factors associated with the good Li response phenotype were panic disorder, manic predominant polarity, manic first episode, age at onset between 15-32 years and family history of BD. Factors most strongly linked to poor outcome were comorbid obsessive-compulsive disorder, alcohol and/or substance misuse, and/or psychosis (symptoms or syndromes).
Network analysis can offer important additional insights to prospective studies of predictors of Li treatment outcomes. It appears to especially help in further clarifying the role of family history of BD (i.e. its direct and indirect associations) and highlighting the positive and negative associations of different subtypes of anxiety disorders with Li response, particularly the little-known negative association between Li response and obsessive-compulsive disorder.
对双相情感障碍 I 型（BD-I）锂（Li）反应的预测因子进行大规模临床研究，并应用当代多元方法来解释潜在预测因子之间的相互关系。
我们使用网络分析来估计 900 名接受锂遗传学联合会招募的 BD-I 患者中，良好 Li 反应（通过新的锂反应回顾评估量表评分算法衡量）的潜在预测因子之间的连接数量和强度。
在考虑潜在预测因子的共同关联后，与良好 Li 反应表型最相关的重要因素是惊恐障碍、躁狂为主极性、躁狂首发、发病年龄在 15-32 岁之间以及 BD 家族史。与不良结局最密切相关的因素是合并强迫症、酒精和/或物质滥用以及/或精神病（症状或综合征）。
网络分析可以为 Li 治疗结果预测因子的前瞻性研究提供重要的额外见解。它似乎特别有助于进一步阐明 BD 家族史的作用（即其直接和间接关联），并突出不同类型焦虑障碍与 Li 反应的正负关联，特别是 Li 反应与强迫症之间鲜为人知的负关联。
