Lithium clinics: theory and practice.

The authors surveyed 19 university-affiliated lithium clinics to examine their clinical practices and standards of care. Most commonly the clinics obtained lithium levels every two months and checked serum creatinine, urinalysis values, and thyroid function yearly. Psychotherapy was used in 18 of the clinics: 45 percent of the unipolar patients and 36 percent of the bipolar patients were receiving individual or group therapy. A variety of mental health personnel staffed the clinics, but in the majority of them physicians were used as the primary staff members for medication visits. The authors compare the characteristics of present-day clinics with those of the early lithium clinics of the late 1960s and early 1970s.