Prædiktorer for non-respons af recidivforebyggende lithiumbehandling

Abstract

The purpose of this prospective study of 78 affective disorder patients adherent to lithium treatment during two years was to identify predictors of importance for non-response. This was defined as patients with more than one readmission during the two years and amounted 29 (37.2%). Young age and female sex showed a strong association to non-response. Social background variables such as educational level, social class etc. were not of importance, but patients who were unfit for work or not married experienced more often non-response. Indices for social stability and support, and recent life events did not show any association to non-response. The diagnostic subgroups, the character of index episodes and free intervals only showed a non-significant trend, but indices for chronic course as many earlier admissions to psychiatric hospitals and long duration of the index episode were informative predictors. A multivariate logistic analysis was applied on both the non-response as the non-response/non-adherence group versus response group. In conclusion it is suggested that patients with substance abuse should not be offered long-term lithium unless intensive control and support is practicable, and patients with a more chronic course and/or many earlier admissions need a more effective prophylactic treatment than lithium can offer.