TY - JOUR
T1 - The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder
AU - Sylvia, Louisa G.
AU - Rabideau, Dustin J.
AU - Nierenberg, Andrew A.
AU - Bowden, Charles L.
AU - Friedman, Edward S.
AU - Iosifescu, Dan V.
AU - Thase, Michael E.
AU - Ketter, Terence
AU - Greiter, Elizabeth A.
AU - Calabrese, Joseph R.
AU - Leon, Andrew C.
AU - Ostacher, Michael J.
AU - Reilly-Harrington, Noreen
N1 - Funding Information:
Dr. Sylvia was a shareholder in Concordant Rater Systems and serves as a consultant for United Biosource Corporation and Clintara. She receives royalties from New Harbinger and research funding from the National Institute of Mental Health and the American Foundation of Suicide Prevention.
Funding Information:
Dr. Nierenberg is a consultant for Abbott Laboratories Astra Zeneca, Basilea, BrainCells Inc., Brandeis University, Bristol-Myers Squibb, Cephalon, Corcept, Eli Lilly & Co., Forest, Genaissance, Genetech, GlaxoSmithKline, Innapharma, Janssen Pharmaceutica, Jazz Pharmaceuticals, Lundbeck, Merck, Methylation Sciences, Novartis, PamLabs, Patient Centered Outcomes Research Institute, PGx Health, Pfizer, Ridge Diagnostics, Roche, Sepracor, Schering-Plough, Shire, Somerset, Sunovion, Takeda, Targacept, and Teva. He is a stakeholder in Appliance Computing, Inc. (MindSite); Brain Cells, Inc., InfoMed (potential share of income) Medavante, Naurex. He receives research support from AHRQ, American Foundation for Suicide Prevention, Bristol-Myers Squibb, Cederroth, Cyberonics, Elan, Forest Pharmaceuticals, GlaxoSmithKline, Janssen Pharmaceutica, Lichtwer Pharma, Eli Lilly, Marriot Foundation, Mylin (formerly Dey Pharmaceuticals), NARSAD, NIMH, Pamlabs, Pfizer, Shire, Stanley Foundation, and Wyeth-Ayerst. Honoraria include MGH Psychiatry Academy in the past 3 years (Prior to 3 years ago, honoraria from Bristol-Myers Squibb, Cyberonics, Forest Pharmaceuticals, GlaxoSmithKline, Eli Lilly, Shire, Wyeth-Ayerst). Dr. Nierenberg receives other income from legal case reviews for CRICO, MBL Publishing for past services as Editor-in-chief of CNS Spectrums, Slack Inc. for services as Associate Editor of Psychiatric Annals, and Editorial Board, Mind Mood Memory, Belvior Publications. He has copyright joint ownership with MGH for Structured Clinical Interview for MADRS and Clinical Positive Affect Scale and additional honoraria from ADURS, American Society for Clinical Psychopharmacology and Zucker Hillside Hospital and Forest and Janssen, Biomedical Development, Boston Center for the Arts, University of Pisa, University of Wisconsin at Madison, University Texas Southwest at Dallas, Health New England and Harold Grinspoon Charitable Foundation and Eli Lilly and AstraZeneca, Brandeis University, International Society for Bipolar Disorder, 2nd East Asian Bipolar Forum, Mid-Atlantic Permanente Research Institute, Up-to-Date.
Funding Information:
Dr. Friedman receives grant support from Novartis, St. Jude Medical, Medtronics, Repligen, Astra-Zeneca, Roche, and Takeda. He receives royalties from Springer.
Funding Information:
Dr. Thase reports no conflicts of interest specifically pertaining to this project. During the past 3 years he has been an advisor/consultant: to Alkermes, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, GlaxoSmithKline, Janssen Pharmaceuticals, Lundbeck, MedAvante, Merck, Mylan, Neuronetics, Otsuka, Pamlab, PharmaNeuroboost, Pfizer, Rexahn, Roche, Shire, Sunovion, Supernus, Takeda, and Teva, as well as the US Food and Drug Administration and the National Institute of Mental Health. During the same time frame, Dr. Thase has received honoraria for talks from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Merck, and Pfizer and he has received research grants from Alkermes, AstraZeneca, Eli Lilly, Forest, GlaxoSmithKline, Otsuka, PharmaNeuroboost, and Roche, as well as the National Institute of Mental Health and the Agency for Healthcare Research and Quality.
Funding Information:
Dr. Ketter receives research support from the Agency for Healthcare Research and Quality, AstraZeneca Pharmaceuticals LP, Cephalon Inc., Eli Lilly and Company, National Institute of Mental Health, Pfizer Inc., and Sunovion Pharmaceuticals. He receives consultant fees from Allergan, Inc., Avanir Pharmaceuticals, Bristol-Myers Squibb Company, Cephalon Inc., Forest Pharmaceuticals, Janssen Pharmaceutica Products, LP, Merck & Co., Inc., Sunovion Pharmaceuticals, and Teva Pharmaceuticals. He has lecture honoraria from Abbott Laboratories, Inc., AstraZeneca Pharmaceuticals LP, GlaxoSmithKline, and Otsuka Pharmaceuticals and receives publication royalties from American Psychiatric Publishing, Inc. In addition, Dr. Ketter׳s spouse is an employee of and holds stock in Janssen Pharmaceuticals.
Funding Information:
Dr. Calabrese has received federal funding from the Department of Defense, Health Resources Services Administration and National Institute of Mental Health. Dr. Calabrese has received research support from Abbott, AstraZeneca, Cephalon, Cleveland Foundation, Eli Lilly, GlaxoSmithKline, Lundbeck, NARSAD, Stanley Medical Research Institute. Dr. Calabrese consulted to or served on advisory boards of Biomedical Development Corporation, Convergent Health Solutions, Dainippon Sumitomo, Elan, Forest, GlaxoSmithKline, Health & Wellness Partners, Hoffman LaRoche, Lilly, Lundbeck, Otsuka, Pfizer, Sunovion, Takeda, Web ID. Dr. Calabrese has provided CME lectures supported by AstraZeneca, Benecke, CME Outfitters, Dainippon Sumotono, Elan, Forest, GlaxoSmithKline, Health & Wellness Partners, Lundbeck, Medwiz Healthcare, Otsuka, Promedica, Spirant Communication Private Limitex, Scientia, Sunovion, Takeda, Teva. No speaker bureaus for the past 7 years. No stock, no equity, and no patents.
Funding Information:
This study was funded by the National Institute of Mental Health , Contract ♯ NO1MH80001 .
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Conclusions Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder.Objectives The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium.Methods In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus "optimal personalized treatment (OPT)", or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning.Results Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over 6 months, patients in both treatment groups improved in quality of life and life functioning (p-Values<0.0001); without a statistically significant difference between the two treatment groups (p-Values>0.05). Within the lithium group, improvement in quality of life and functioning was not associated with concurrent lithium levels at week 12 or week 24 (p-Values>0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over 6 months.
AB - Conclusions Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder.Objectives The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium.Methods In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus "optimal personalized treatment (OPT)", or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning.Results Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over 6 months, patients in both treatment groups improved in quality of life and life functioning (p-Values<0.0001); without a statistically significant difference between the two treatment groups (p-Values>0.05). Within the lithium group, improvement in quality of life and functioning was not associated with concurrent lithium levels at week 12 or week 24 (p-Values>0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over 6 months.
KW - Bipolar disorder
KW - Life functioning
KW - Lithium
KW - Quality of life
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U2 - 10.1016/j.jad.2014.08.019
DO - 10.1016/j.jad.2014.08.019
M3 - Article
C2 - 25194782
AN - SCOPUS:84908410290
VL - 169
SP - 144
EP - 148
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -