[Screening and evaluation on predictive factors in lithium carbonate maintenance treatment of manic-depressive...

The prophylactic effect of lithium carbonate was studied prospectively in 95 patients with recurrent manic-depressive disorders. Maintenance lithium treatment started at the stage of recovery after previous episodes lasting for 20-24 months. Of all the 95 patients, 55 cases (57.9%) were responders, with no relapse during the follow-up period; whereas the other 40 cases (42.1%) were non-responders, having at least one relapse occurred from 4 to 12 months after the index episode. Of the parameters studied, (1) minor primary episode; (2) higher lithium RBC/plasma ratio (greater than 0.4); (3) increase of plasma calcium level during lithium treatment; (4) extraversion-cycloid personality featured by EPQ have higher predictive sensitivity and specificity (greater than 70%) and maybe used as the core predictive factors for long-term outcome in lithium treatment. The other parameters, the age of unset, frequency of episodes, euphoric and grandiose symptoms, clinical respond of first lithium anti-episode medications and lithium clearance can also be used as corresponding predictive factors in selecting cases for long-term lithium treatment.