Abstract | 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.
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Authors | Michael Berk, Alan Brnabic, Seetal Dodd, Katarina Kelin, Mauricio Tohen, Gin S Malhi, Lesley Berk, Philippe Conus, Patrick D McGorry |
Journal | Bipolar disorders
(Bipolar Disord)
Vol. 13
Issue 1
Pg. 87-98
(Feb 2011)
ISSN: 1399-5618 [Electronic] Denmark |
PMID | 21320256
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2011 John Wiley and Sons A/S. |
Chemical References |
- Antipsychotic Agents
- Benzodiazepines
- Olanzapine
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Topics |
- Adult
- Age of Onset
- Antipsychotic Agents
(therapeutic use)
- Benzodiazepines
(therapeutic use)
- Bipolar Disorder
(classification, diagnosis, drug therapy, psychology)
- Disease Progression
- Double-Blind Method
- Early Diagnosis
- Female
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Models, Psychological
- Olanzapine
- Prognosis
- Psychiatric Status Rating Scales
- Recurrence
- Treatment Outcome
- Young Adult
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