Prediction of affective psychoses response to lithium prophylaxis. The role of socio-demographic, clinical, psychological and biological variables.
A set of socio-demographic, clinical, psychological and biological variables was examined in 100 patients diagnosed according to Perris as bipolar affective psychotics or unipolar depressive psychotics, maintained on prophylactic lithium for 2 years and divided into responders and non-responders to this treatment on the basis of strict criteria. The results confirmed the potential role of four indices as predictors of response to prophylaxis: a positive family history of bipolar affective illness and a high red blood cell/plasma lithium ratio (positive predictors) and the presence of the HLA-A3 antigen and a high score on the Neuroticism Scale of the Eysenck Personality Questionnaire (negative predictors). A stepwise discriminant analysis showed that neuroticism score, lithium ratio and HLA-A3 antigen, taken together, correctly classified 74.6% of responders and 68.3% of non-responders. It is hypothesized that these variables as a group may be of practical value in predicting response to lithium prophylaxis, and that pharmacogenetic and, perhaps, personality factors may be involved in treatment failures.
D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D001714:Bipolar Disorder / Q000188:drug therapy / Q000235:genetics; D003866:Depressive Disorder / Q000188:drug therapy; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D015234:HLA-A Antigens; D015791:HLA-A3 Antigen; D006801:Humans; D008094:Lithium / Q000097:blood / Q000627:therapeutic use*; D016651:Lithium Carbonate; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
D006680:HLA Antigens; D015234:HLA-A Antigens; D015791:HLA-A3 Antigen; D016651:Lithium Carbonate; D008094:Lithium