Does prophylaxis-delay in bipolar disorder influence outcome? Results from a long-term study of 147 patients.
OBJECTIVE
This study investigated the impact of latency (the time between illness onset and initiation of prophylactic treatment) on the outcome of prophylaxis in bipolar disorders.


METHODS
The effect of prophylaxis delay (latency) on the course of illness was assessed in 147 patients. Dependent variables were: reduction of days spent in the hospital (prior to vs. during prophylaxis), time to first recurrence, and Morbidity-Index during prophylaxis (lithium or carbamazepine). Latency and other independent variables were tested using a multivariate approach.


RESULTS
Latency (9.3 years on average) had no significant effect on the subsequent response. Illness severity prior to prophylaxis, however, did predict the relative response. The course of illness during treatment could not be predicted by any one factor.


CONCLUSIONS
The delay in initiating prophylaxis appears to have no influence on prophylaxis outcome. Instead, those whose illness was more severe were treated earlier and these patients subsequently showed a relatively greater response. If severity is not controlled for as part of the analysis, latency may be mistaken as an important predictor for response.
Baethge
C
C
Klinik für Psychiatrie und Psychotherapie, Freie Universität Berlin, Berlin, Germany. christopher.baethge@medizin.fu-berlin.de
Smolka
M N
MN
Gruschka
P
P
Berghöfer
A
A
Schlattmann
P
P
Bauer
M
M
Altshuler
L
L
Grof
P
P
Müller-Oerlinghausen
B
B
D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology*; D002220:Carbamazepine / Q000008:administration & dosage* / Q000494:pharmacology*; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D018021:Lithium Chloride / Q000008:administration & dosage* / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors
D018692:Antimanic Agents; D002220:Carbamazepine; D018021:Lithium Chloride