Prediction of treatment response in mania

We evaluated the relation of responsivity of somatic treatment and heterogeneity in a sample of III manics (diagnosed by Feighner criteria) by assessing demographic, clinical, and family illness variables-historical variables potentially related to abnormal brain function and cortical function as measured by neuropsychological and EEG techniques. Except for a positive, perhaps unimportant, relationship between an abnormal EEG and improvement, we could find little evidence for biological differences between responders and nonresponders to treatment. However, 30% of the nonresponders and only 4% of the responders prematurely terminated treatment, suggesting a strong nonbiological mechanism underlying treatment failure. We conclude that there are as yet no adequate predictors of short-term treatment response in mania and that evidence for heterogeneity in mania must be sought elsewhere.