Research reports on treatments for bipolar disorder: preliminary assessment of methodological quality.
OBJECTIVE
To assess frequencies of types of publications about bipolar disorder (BD) and evaluate methodological quality of treatment studies.


METHODS
We classified 100 randomly selected articles (1998-2002) from five psychiatric journals with highest impact ratings, by topic areas, and assessed methods employed in treatment studies.


RESULTS
Topics ranked: treatment (41%; 37% on pharmacotherapy) > biology (31%) > psychopathology (14%) = miscellaneous (14%). Of treatment studies, only 19% of original articles were randomized, 15% were relatively large (n > or = 50) but non-randomized, 65% were small non-randomized, case-series or -reports, and 53% relied on baseline-to-endpoint contrasts without a control group. Patient dropout rates were > or =40% in 43% of prospective studies. Only two reports provided confidence intervals; one included a power analysis, and 53% included no references on study design or statistical methods.


CONCLUSIONS
Even in highly respected journals, the typical methodological quality of recent reports on therapeutics for BD was unexpectedly limited, and psychopathology and psychotherapies were little studied.
Soldani
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F
Department of Psychiatry, Harvard Medical School, Boston, MA 02478, USA. federico@post.harvard.edu
Ghaemi
S N
SN
Baldessarini
R J
RJ
D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data; D010507:Periodicity; D011643:Publishing / Q000706:statistics & numerical data*; D012106:Research / Q000706:statistics & numerical data*; D012107:Research Design