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Research reports on treatments for bipolar disorder: preliminary assessment of methodological quality
F Soldani1, S N Ghaemi, R J Baldessarini
1Department of Psychiatry, Harvard Medical School, Boston, MA 02478, USA. federico@post.harvard.edu
Objective:
To assess frequencies of types of publications about bipolar disorder (BD) and evaluate methodological quality of treatment studies.
Method:
We classified 100 randomly selected articles (1998-2002) from five psychiatric journals with highest impact ratings, by topic areas, and assessed methods employed in treatment studies.
Results:
Topics ranked: treatment (41%; 37% on pharmacotherapy) > biology (31%) > psychopathology (14%) = miscellaneous (14%). Of treatment studies, only 19% of original articles were randomized, 15% were relatively large (n > or = 50) but non-randomized, 65% were small non-randomized, case-series or -reports, and 53% relied on baseline-to-endpoint contrasts without a control group. Patient dropout rates were > or =40% in 43% of prospective studies. Only two reports provided confidence intervals; one included a power analysis, and 53% included no references on study design or statistical methods.
Conclusion:
Even in highly respected journals, the typical methodological quality of recent reports on therapeutics for BD was unexpectedly limited, and psychopathology and psychotherapies were little studied.
