Abstract
In prophylactic treatment of patients having bipolar disorders (BD), lithium, no doubt, plays an important role. The hypothesis of this register study was that said patients, thanks to lithium therapy, would spend fewer and shorter stays in the hospital. We used ipsative control techniques in a study of 60 patients during two periods of 20 months each, one before and the other after the lithium therapy began. We found significant statistical differences regarding the average number (p<.004) and length (p<.001) of stays in hospital comparing pre-lithium treatment to post-lithium treatment. These averages also revealed statistical differences with regard to age (number of stays,p<.002; length of stays,p<.047), with older patients obtaining greater benefit from treatment than younger patients. There were no such differences with regard to gender (number of stays,p<.602; length of stays,p<.584). That BD patients respond favorably to lithium treatment is a well-known finding. On the other hand, we know of no previous study indicating that older patients obtain better results with lithium therapy than do younger patients. Yet because this study occurred over a 20-year period, there are some grounds that probably would substantiate this comparative statement; namely, that one does comply more easily as one gets older, that diagnoses are currently more accurate than they were before, and that care routines have improved.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association (1987).Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.), American Psychiatric Association, Washington, DC.
Angst, J., Weiss, P., and Groff, P. (1970). Lithium prophylaxis in recurrent affective disorder.Br. J. Psychiatry, 116: 601–611.
Baastrup, P. C., and Schou, A. M. (1967). Lithium as a prophylactic agent. Its effect against recurrent depressions and maniac-depressive psychosis.Arch. Gen. Psychiat. Chicago 16: 162–172.
Baastrup, P. C., Poulsen, J. C., Schou, M., Thomsen, K., and Amdisen, A. (1970). Prophylactic lithium: Double-blind discontinuation in manic-depressive and recurrent depressive disorders.Lancet 2: 326–333.
Basolo-Kunzer, M. (1994). Caring for families of psychiatric patients.Nurs. Clin. North Am. 29: 73–79.
Cade, J. F. (1949). Lithium salts in the treatment of psychotic excitement.Med. J. Austral. 36: 349–352.
Consensus Development Panel (1985). Mood disorders: Pharmacologic prevention of recurrence.Am. J. Psychiat. 142: 469–475.
Dinan, T. G., and Kohen, D. (1989). TD in bipolar affective disorder: Relationship to lithium therapy.Br. J. Psychiat. 155: 55–57.
Faedda, G. L., Tondo, L., Ross, J., Baldessarini, R. J., Suppes, T., and Tohen, M. (1993). Outcome after rapid vs gradual discontinuation of lithium treatment in bipolar disorders.Arch. Gen. Psychiat. 50: 448–455.
Fieve, R. R., and Peselow, E. D. (1983). Lithium-clinical applications. In Burrows, G. D., Norman, T. R., and Davies, B. (eds.),Drugs in Psychiatry, Vol. 1. Antidepressants Elsevier-North Holland, Biomedical Press, Amsterdam, pp. 277–321.
Harrow, M., Goldberg, J. F., Grossman, L. S., and Meltzer, H. Y. (1990). Outcome in manic disorders: Naturalistic follow-up study.Arch. Gen. Psychiat. 47: 665–671.
Janowsky, D., Melitta, L., and Epstein, R. (1970). Playing the manic game.Arch. Gen. Psychiat. 22: 252–261.
Keller, M. B., Lavori, P. W., Kane, J. M., Gelenberg, A. L., Rosenbaum, J. F., Walzer, E. A., and Baker, L. A. (1992). Subsyndromal symptoms in bipolar disorder: A comparison of standard and low serum levels of lithium.Arch. Gen. Psychiat. 49: 371–376.
Keltner, N. L., and Folks, D. G. (1991). Alternatives to lithium in the treatment of bipolar disorder.Perspect. Psychiat. Care 27: 36–37.
Klein, E., Lavie, P., Meiraz, R., Sadeh, A., and Lenox, R. H. (1992). Increased motor activity and recurrent manic episodes: Predictors of rapid relapse in remitted bipolar disorder patients after lithium disocntiuation.Biol. Psychiat. 31: 279–284.
Knisely, J. E., and Northouse, L. (1994). The relationship between social support, help-seeking behavior, and psychological distress in psychiatric clients.Arch. Psych. Nurs. VIII: 357–365.
Lenski, P., and Legget, J. C. (1960). Caste, class and defence in the research interview.Am. J. Sociol. 65: 463–465.
Loukissa, D. A. (1995). Family burden in chronic mental illness: A review of research studies.J. Adv. Nurs. 21: 248–255.
Lundman, I., Asplund, K., and Norberg, A. (1990). Living with diabetes: Perceptions of well-being.Res. Nurs. Health 13: 255–262.
Maj, M., Pirozzi, R., and Kemali, D. (1991). Long-term outcome of lithium prophylaxis in bipolar patients.Arch. Gen. Psychiat. 48: 772.
Margo, A., and McMahon, P. (1982). Lithium withdrawal triggers psychosis.Br. J. Psychiat. 141: 407–410.
Murray, J. B. (1994). Lithium maintenance therapy for bipolar I patients: Possible refractoriness to reinstitution after discontinuation.Psychol. Rep. 74: 355–361.
Nilsson, A., and Axelsson, R. (1989). Effects of long-term lithium treatment on thyroid and renal function (serum creatinine and maximal urine osmolatity)—a prospective study in psychiatric patients.Curr. Ther. Res. 46: 85–102.
O'Connell, R. A., Mayo, J. A., Flatow, L., Cuthbertson, B., and O'Brien, B. E. (1991). Outcome of bipolar disorder on long-term treatment with lithium.Br. J. Psychiat. 159: 123–129.
Peselow, E. D., Fieve, R. N., Difiglia, C., and Sanfilipo, M. P. (1994). Lithium prophylaxis of bipolar illness: The value of combination treatment.Br. J. Psychiat. 164: 208–214.
Post, R. M., Leverich, G. S., Altshuler, L., and Mikaluaskas, K. (1992). Lithium-discontinuation-induced refractoriness: Preliminary observations.Am. J. Psychiat. 149: 1727–1729.
Rifkin, A. (1980). Terminating lithium treatment. In Johnson, F. N. (ed.),Handbook of Lithium Therapy, MTP Press, Lancaster, England, pp. 255–264.
Schou, M. (1979). Artistic productivity and lithium prophylaxis in manic-depressive illness.Br. J. Psychiat. 136: 97–103.
Schou, M. (1987). Clinically significant lithium interactions: Review and recommendations.Eur. J. Psychiat. 1: 42–47.
Strober, M., Morrell, W., Lampert, C., and Burroughts, J. (1990). Relapse following discontinuation of lithium maintenance therapy in adolescents with bipolar I illness: A naturalistic study.Am. J. Psychiat. 147: 457–461.
Suppes, T., Baldessarini, R. J., Faedda, G. L., and Tohen, M. (1991). Risk of recurrence following discontinuation of lithium treatment in bipolar disorder.Arch. Gen. Psychiat. 48: 1082–1088.
von Essen, L., and Sjödén, P.-O. (1995). Perceived occurrence and importance of caring behaviours among patients and staff in psychiatric, medical and surgical care.J. Adv. Nurs. 21: 266–76.
Winokur, G., Coryell, W., Keller, M., Ednicott, J., and Akiskal, H. (1993). A prospective follow-up of patients with bipolar and primary unipolar affective disorders.Arch. Gen. Psychiat. 50: 457–465.
Woods, N. F., and Catanzaro, M. (1988).Nursing Research: Theory and Practice, C. V. Mosby, St. Louis/Washington, DC/Toronto.
Zis, A. P., Grof, P., Webster, M., and Goodwin, F. K. (1980). Prediction of relapse in recurrent affective disorder.Psychopharmacol. Bull. 16: 47–49.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Andersson, E., Antonsson, M., Corin, B. et al. The preventive effect of lithium therapy on bipolar disorder patients, with special reference to gender and age. Int J Rehab Health 1, 203–209 (1995). https://doi.org/10.1007/BF02214732
Issue Date:
DOI: https://doi.org/10.1007/BF02214732