Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort
Introduction Evidence for lithium as a maintenance treatment for bipolar disorder type II remains limited since most treatment-prevention studies focus on bipolar disorder type I or do not distinguish between types of bipolar disorder. Objectives To compare the impact of lithium discontinuation...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821002388/type/journal_article |
| _version_ | 1827754222867709952 |
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| author | L. Öhlund M. Ott M. Bergqvist S. Oja R. Lundqvist M. Sandlund E. Salander Renberg U. Werneke |
| author_facet | L. Öhlund M. Ott M. Bergqvist S. Oja R. Lundqvist M. Sandlund E. Salander Renberg U. Werneke |
| author_sort | L. Öhlund |
| collection | DOAJ |
| description |
Introduction
Evidence for lithium as a maintenance treatment for bipolar disorder type II remains limited since most treatment-prevention studies focus on bipolar disorder type I or do not distinguish between types of bipolar disorder.
Objectives
To compare the impact of lithium discontinuation on hospital utilisation in patients with bipolar disorder type I or schizoaffective disorder and patients with bipolar disorder type II or other bipolar disorder.
Methods
Mirror-image study, examining hospital utilisation within two years before and after lithium discontinuation as part of LiSIE, a retrospective cohort study into effects and side-effects of lithium for the maintenance treatment of bipolar disorder as compared to other mood stabilisers.
Results
For the whole sample, the number of admissions increased from 86 to 185 admissions after lithium discontinuation, with the mean number of admissions/patient/review period doubling from 0.44 to 0.95 (p < 0.001). The number of bed days increased from 2218 to 4240, with the mean number of bed days/patient/review period doubling from 11 to 22 (p = 0.025). This increase in admissions and bed days was exclusively attributable to patients with bipolar disorder type I or schizoaffective disorder.
Conclusions
Our findings suggest that due to a higher relapse risk in patients with bipolar disorder type I or schizoaffective disorder there is a need to apply a higher threshold for discontinuing lithium than for patients with bipolar disorder type II or other bipolar disorder.
Disclosure
Michael Ott has been a scientific advisory board member of Astra Zeneca Sweden, Ursula Werneke has received funding for educational activities on behalf of Norrbotten Region (Masterclass Psychiatry Programme 2014–2018 and EAPM 2016, Luleå, Sweden): Astra
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| first_indexed | 2024-03-11T07:47:13Z |
| format | Article |
| id | doaj.art-589ee01c8d96470c9b5ddbc60c0963d0 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:47:13Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-589ee01c8d96470c9b5ddbc60c0963d02023-11-17T05:07:27ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S79S7910.1192/j.eurpsy.2021.238Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohortL. Öhlund0M. Ott1M. Bergqvist2S. Oja3R. Lundqvist4M. Sandlund5E. Salander Renberg6U. Werneke7Sunderby Research Unit, Department Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, SwedenDepartment Of Public Health And Clinical Medicine, Division Of Medicine, Umeå University, Umeå, SwedenDepartment Of Psychiatry, Piteå Älvdals hospital, Piteå, SwedenSunderby Hospital, Department of Psychiatry, Luleå, SwedenDepartment Of Public Health And Clinical Medicine, Sunderby Research Unit, Umeå University, Umeå, SwedenDepartment Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, SwedenDepartment Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, SwedenSunderby Research Unit, Department Of Clinical Sciences, Division Of Psychiatry, Umeå University, Umeå, Sweden Introduction Evidence for lithium as a maintenance treatment for bipolar disorder type II remains limited since most treatment-prevention studies focus on bipolar disorder type I or do not distinguish between types of bipolar disorder. Objectives To compare the impact of lithium discontinuation on hospital utilisation in patients with bipolar disorder type I or schizoaffective disorder and patients with bipolar disorder type II or other bipolar disorder. Methods Mirror-image study, examining hospital utilisation within two years before and after lithium discontinuation as part of LiSIE, a retrospective cohort study into effects and side-effects of lithium for the maintenance treatment of bipolar disorder as compared to other mood stabilisers. Results For the whole sample, the number of admissions increased from 86 to 185 admissions after lithium discontinuation, with the mean number of admissions/patient/review period doubling from 0.44 to 0.95 (p < 0.001). The number of bed days increased from 2218 to 4240, with the mean number of bed days/patient/review period doubling from 11 to 22 (p = 0.025). This increase in admissions and bed days was exclusively attributable to patients with bipolar disorder type I or schizoaffective disorder. Conclusions Our findings suggest that due to a higher relapse risk in patients with bipolar disorder type I or schizoaffective disorder there is a need to apply a higher threshold for discontinuing lithium than for patients with bipolar disorder type II or other bipolar disorder. Disclosure Michael Ott has been a scientific advisory board member of Astra Zeneca Sweden, Ursula Werneke has received funding for educational activities on behalf of Norrbotten Region (Masterclass Psychiatry Programme 2014–2018 and EAPM 2016, Luleå, Sweden): Astra https://www.cambridge.org/core/product/identifier/S0924933821002388/type/journal_articlebipolar disorderlithiumAdmissionmood stabiliser |
| spellingShingle | L. Öhlund M. Ott M. Bergqvist S. Oja R. Lundqvist M. Sandlund E. Salander Renberg U. Werneke Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort European Psychiatry bipolar disorder lithium Admission mood stabiliser |
| title | Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort |
| title_full | Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort |
| title_fullStr | Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort |
| title_full_unstemmed | Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort |
| title_short | Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: A mirror-image study based on the lisie retrospective cohort |
| title_sort | psychiatric hospital utilisation following lithium discontinuation in patients with bipolar i or ii disorder a mirror image study based on the lisie retrospective cohort |
| topic | bipolar disorder lithium Admission mood stabiliser |
| url | https://www.cambridge.org/core/product/identifier/S0924933821002388/type/journal_article |
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