Prediction of Treatment Response in Mania

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Abstract
• We evaluated the relation of responsivity to somatic treatment and heterogeneity in a sample of 111 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.

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