Predictors of outcome in prophylactic lithium treatment: a 2-year prospective study

The purpose of this study of 133 affective disorder patients consecutively referred to start prophylactic lithium treatment was to identify informative predictors of outcome. Non-adherence to treatment was mainly predicted by substance abuse and many earlier admissions. Non-response among the 78 patients adhering to lithium treatment was mainly predicted by female sex, young age and previously chronic course. The overall response rate was rather poor and an excess mortality rate was found. It is suggested that patients with substance abuse should not be offered prophylactic lithium treatment unless intensive control and support is practicable, and patients with a chronic course need a more effective treatment than lithium can offer.