Hostname: page-component-7c8c6479df-hgkh8 Total loading time: 0 Render date: 2024-03-28T15:40:39.111Z Has data issue: false hasContentIssue false

Social Support and Long-Term Lithium Outcome

Published online by Cambridge University Press:  29 January 2018

Ralph A. O'Connell*
Affiliation:
St. Vincent's Hospital and Medical Center, New York Medical College, 144 West 12th St., New York NY, 10011, USA
Julia A. Mayo
Affiliation:
Clinical Studies and Evaluation, St. Vincent's, New York Medical College
Leonard K. Eng
Affiliation:
St. Vincent's
J. Sidney Jones
Affiliation:
St. Vincent's
Richard H. Gabel
Affiliation:
In-patient Service, St. Vincent's, New York Medical College
*
Correspondence

Summary

The failure rate in long-term lithium treatment of bipolar affective disorder is in the range of 20 to 30%, even with rigorous diagnostic criteria and adequate serum lithium levels. This may be due to a variety of biologic and psychosocial factors. Psychosocial factors affecting treatment outcome were studied in 60 RDC diagnosed bipolar patients treated with lithium for one year. Outcome was measured using an affective episode score, a social adjustment scale and a global assessment scale. Social support was the factor most strongly correlated with a good outcome on all three measures.

Type
Papers
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angst, J., Grof, P., Baastrup, P., et al (1970) Lithium prophylaxis in recurrent affective disorders. British Journal of Psychiatry, 116, 604616.CrossRefGoogle ScholarPubMed
Baastrup, R. C., Poulse, J., Schou, M., et al (1970) Prophylactic lithium: double blind discontinuation in manic depression and recurrent depressive disorders. Lancet, ii, 326330.Google Scholar
Brown, G. W. & Harris, T. (1978) The Social Origins of Depression. London: Tavistock Publications.Google Scholar
Brugha, T., Conroy, R., Walsh, N., et al (1982) Social networks, attachments, and support in minor affective disorders: a replication. British Journal of Psychiatry, 141, 249255.Google Scholar
Carroll, B. J. (1979) Predictors of treatment outcome with lithium. Archives of General Psychiatry, 36, 870878.Google Scholar
Clayton, P., Halikes, J. Maurice, W. (1974) The bereavement of the widow. Diseases of the Nervous System, 32, 597604.Google Scholar
Clayton, P., Hirschfeld, R. M. A. Larkin, B. H. (1977) Personal Resources Inventory (PRI). Rockville, Maryland: National Institutes of Mental Health, Clinical Research Branch.Google Scholar
Coppen, A., Noguera, R., Bailey, J., et al (1971) Prophylactic lithium in affective disorders. Lancet ii, 275279.Google Scholar
Dohrenwend, B. S. & Dohrenwend, B. P. (1974) Stressful Life Events: Their Nature and Effects. New York: John Wiley.Google Scholar
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview: the schedule of affective disdorders and schizophrenia. Archives of General Psychiatry, 35, 837844.Google Scholar
Engel, G. L. (1980) The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535544.Google Scholar
Flaherty, J. A., Gaviria, F. M., Black, E. M., et al (1983) The role of social support in the functioning of patients with unipolar depression. A merican Journal of Psychiatry, 140, 474475.Google Scholar
Freyhan, F. A., O'Connell, R. A. & Mayo, J. A. (1970) Treatment of mood disorders with lithium carbonate. International Pharmacopsychiatry, 5, 137148.CrossRefGoogle Scholar
Henderson, S. (1981) Social relationships, adversity and neurosis: an analysis of prospective observations. British Journal of Psychiatry, 138, 391398.Google Scholar
Holungshead, A. B. & Redlich, F. C. (1958) Social Class and Mental Illness: A Community Study. New York: Wiley.Google Scholar
Hullin, R. P., McDonald, R. & Allsop, M. N. (1972) Prophylactic lithium in recurrent affective disorders. Lancet i, 10441046.Google Scholar
Kocsis, J. H. & Stokes, P. E. (1979) Lithium maintenance: factors affecting outcome. American Journal of Psychiatry, 36, 563566.Google Scholar
Mayo, J. A. (1979) Marital therapy with manic-depressive patients treated with lithium. Comprehensive Psychiatry, 20, 419426.CrossRefGoogle ScholarPubMed
Mayo, J. A. O'Connell, R. A. & O'Brien, J. D. (1979) Families of manic-depressive patients: effect of treatment. American Journal of Psychiatry, 136, 15351539.Google Scholar
Melia, P. I. (1970) Prophylactic lithium: a double blind trial in recurrent affective disorders. British Journal of Psychiatry, 116, 621624.CrossRefGoogle ScholarPubMed
O'Connell, R. A. & Mayo, J. A. (1981) Lithium: a biopsychosocial perspective. Comprehensive Psychiatry, 22, 8793.Google Scholar
Perris, C. Strandman, E. & Wahlby, L. (1979) HL-A antigens and the response to prophylactic lithium. Neuropsychobiology, 5, 114118.Google Scholar
Prien, R. F., Caffey, E. M. & Klett, C. J. (1974) Factors associated with treatment success in lithium carbonate prophylaxis. Archives of General Psychiatry, 31, 189192.Google Scholar
Prien, R. F., Kupfer, D. J., Mansky, P. A., et al (1984) Drug therapy in the prevention of recurrences of unipolar and bipolar affective disorders. Archives of General Psychiatry, 41, 10961104.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978a) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.Google Scholar
Spitzer, R. L., Gibbon, M. & Endicott, J. (1978b) Global Assessment Scale (GAS). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Strauss, J. S. & Carpenter, W. T. (1977) Prediction of outcome in schizophrenia. III. Five year outcome and its predictors. Archives of General Psychiatry, 34, 159163.Google Scholar
Weissman, M. M. & Paykel, E. S. (1974) The Depressed Woman: A Study of Social Relationships. Chicago: University of Chicago Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.