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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention
Bipolar Disorders, Volume 13, No. 1, Year 2011
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Description
Objective: The staging model suggests that early stages of bipolar disorder respond better to treatments and have a more favourable prognosis. This study aims to provide empirical support for the model, and the allied construct of early intervention. Methods: Pooled data from mania, depression, and maintenance studies of olanzapine were analyzed. Individuals were categorized as having had 0, 1-5, 6-10, or >10 prior episodes of illness, and data were analyzed across these groups. Results: Response rates for the mania and maintenance studies ranged from 52-69% and 10-50%, respectively, for individuals with 1-5 previous episodes, and from 29-59% and 11-40% for individuals with >5 previous episodes. These rates were significantly higher for the 1-5 group on most measures of response with up to a twofold increase in the chance of responding for those with fewer previous episodes. For the depression studies, response rates were significantly higher for the 1-5 group for two measures only. In the maintenance studies, the chance of relapse to either mania or depression was reduced by 40-60% for those who had experienced 1-5 episodes or 6-10 episodes compared to the >10 episode group, respectively. This trend was statistically significant only for relapse into mania for the 1-5 episode group (p=0.005). Conclusion: Those individuals at the earliest stages of illness consistently had a more favourable response to treatment. This is consistent with the staging model and underscores the need to support a policy of early intervention. © 2011 John Wiley and Sons A/S.
Authors & Co-Authors
Berk, Michael
Australia, Geelong
Deakin University
Australia, Melbourne
Orygen Youth Health
Australia, Geelong
Barwon Health
Australia, Melbourne
The Florey
Australia, Melbourne
University of Melbourne
Brnabic, Alan J.M.
Australia, Sydney
Eli Lilly Australia Pty Ltd.
Dodd, Seetal M.
Australia, Geelong
Deakin University
Australia, Geelong
Barwon Health
Tohen, Mauricio F.
United States, San Antonio
University of Texas Health Science Center at San Antonio
Malhi, Gin Singh
Australia, Sydney
The University of Sydney
Conus, Philippe O.
Australia, Melbourne
Orygen Youth Health
Australia, Melbourne
University of Melbourne
McGorry, Patrick D.
Australia, Melbourne
Orygen Youth Health
Australia, Melbourne
University of Melbourne
Statistics
Citations: 176
Authors: 7
Affiliations: 8
Identifiers
Doi:
10.1111/j.1399-5618.2011.00889.x
ISSN:
13995618
Research Areas
Health System And Policy
Mental Health
Study Design
Randomised Control Trial