Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Is treatment for bipolar disorder more effective earlier in illness course? A comprehensive literature review

Tools
- Tools
+ Tools

Joyce, Katie, Thompson, Andrew David and Marwaha, Steven (2016) Is treatment for bipolar disorder more effective earlier in illness course? A comprehensive literature review. International Journal of Bipolar Disorders, 4 . 19. doi:10.1186/s40345-016-0060-6 ISSN 2194-7511.

[img] PDF
WRAP_art%3A10.1186%2Fs40345-016-0060-6.pdf - Published Version - Requires a PDF viewer.
Available under License Creative Commons Attribution 4.0.

Download (1650Kb)
Official URL: http://dx.doi.org/10.1186/s40345-016-0060-6

Request Changes to record.

Abstract

Background:
We aimed to investigate a key element of the early intervention approach whether treatment at an earlier stage of bipolar disorder is more effective than later in its course.

Methods:
A comprehensive literature review using Medline, Embase, Psychinfo, PsycArticle, and Web of Science, as data sources, with a subsequent narrative synthesis. Study quality was assessed using the Cochrane risk of bias method.

Results:
Our search strategy yielded eight primary papers and two meta-analyses (of psychological therapies and Olanzapine) in total representing 8942 patients. Five studies focused on comparisons between first and multiple episodes, and the others on fewer vs more episode categories. There was a consistent finding, suggesting treatment in earlier illness stage resulted in better outcomes in terms of response, relapse rate, time to recurrence, symptomatic recovery, remission, psychosocial functioning, and employment. This effect was found for pharmacological (Lithium, Olanzapine, Divalproex) and psychological treatments.

Limitations:
There was high risk of selection, performance, and attrition bias in most studies. First admission or presentation is unlikely to equate to first episode, because of the duration of untreated illness. Some patients having experienced multiple episodes could be “treatment resistant”. Study heterogeneity precluded meta-analysis.

Conclusions:
Psychological and pharmacological treatments in the early stages of illness are more effective than in the later stages of bipolar disorder across multiple domains. There is a first episode and the early phase effect. Consistent with the staging model of illness, findings provide evidence for the clinical utility of an early intervention approach in bipolar disorder to improve patient outcomes.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Manic-depressive illness -- Treatment, Systematic reviews (Medical research) , Psychotherapy, Biological psychiatry
Journal or Publication Title: International Journal of Bipolar Disorders
Publisher: SpringerOpen
ISSN: 2194-7511
Official Date: 9 September 2016
Dates:
DateEvent
9 September 2016Published
30 August 2016Accepted
22 June 2016Submitted
Volume: 4
Article Number: 19
DOI: 10.1186/s40345-016-0060-6
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 13 September 2016
Date of first compliant Open Access: 13 September 2016

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us