Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention

Berk, Michael, Brnabic, Alan, Dodd, Seetal, Kelin, Katarina, Tohen, Mauricio, Malhi, Gin S., Berk, Lesley, Conus, Philippe and McGorry, Patrick D. 2011, 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, vol. 13, no. 1, pp. 87-98, doi: 10.1111/j.1399-5618.2011.00889.x.

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Title Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention
Author(s) Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Brnabic, Alan
Dodd, SeetalORCID iD for Dodd, Seetal orcid.org/0000-0002-7918-4636
Kelin, Katarina
Tohen, Mauricio
Malhi, Gin S.
Berk, LesleyORCID iD for Berk, Lesley orcid.org/0000-0002-3677-7503
Conus, Philippe
McGorry, Patrick D.
Journal name Bipolar disorders
Volume number 13
Issue number 1
Start page 87
End page 98
Total pages 12
Publisher Wiley - Blackwell
Place of publication Malden, Mass
Publication date 2011-02
ISSN 1398-5647
1399-5618
Summary 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
Notes First published online 14 February 2011.
Language eng
DOI 10.1111/j.1399-5618.2011.00889.x
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2011, John Wiley and Sons
Persistent URL http://hdl.handle.net/10536/DRO/DU:30035522

Document type: Journal Article
Collection: School of Medicine
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