Long-term outcome of lithium prophylaxis in bipolar disorder with mood-incongruent psychotic features: a prospective study.
BACKGROUND
No study has assessed systematically up to now the long-term outcome of lithium prophylaxis in bipolar patients with vs. without mood-incongruent psychotic features.


METHODS
All bipolar patients with mood-incongruent psychotic features who started lithium prophylaxis at a lithium clinic during 14 years were followed up prospectively for 5 years, along with a control group of non-psychotic bipolars.


RESULTS
Psychotic patients were significantly less likely than controls to be still on lithium after 5 years, and to present a reduction of at least 50% of time spent in hospital during the lithium treatment period compared with a pre-treatment period of the same duration. The time to 50% risk of readmission was significantly increased among both groups during lithium treatment. 39.6% of prospective episodes in psychotic patients did not include mood-incongruent psychotic features.


CONCLUSIONS
This is a naturalistic study carried out at a lithium clinic. No control group of bipolar patients who did not receive lithium was available.


CONCLUSIONS
Lithium exerts a significant impact on the course of bipolar disorder with mood-incongruent psychotic features, although this impact is less pronounced than in classical manic-depressive illness.
Maj
Mario
M
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, I-80138 Napoli, Italy. majmario@tin.it
Pirozzi
Raffaele
R
Bartoli
Luca
L
Magliano
Lorenza
L
D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000517:prevention & control*; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010359:Patient Readmission; D011379:Prognosis; D011446:Prospective Studies
D018692:Antimanic Agents; D016651:Lithium Carbonate