Melancholic features and response to lithium prophylaxis in mood disorders

Clinical predictors of the efficacy of lithium prophylaxis in mood disorder s have great potential value. Melancholic features during depressive phases have been both proposed and rejected as valid predictors of favorable outc ome. The aim of the present study is to describe the validity of melancholi c features during depressive phases as predictors of the prophylactic effic acy of lithium. Sixty-one subjects affected by bipolar (n = 51) and major d epressive (n = 10) disorder were followed prospectively for an average of 5 3 months. All subjects were evaluated as a lifetime perspective at intake, by the Operational Criteria checklist for psychotic illness (OPCRIT). Melan cholic features were correlated with outcome only when controlling for time of first lithium administration. These two variables accounted for more th an 30% of the total variance in lithium response. Others clinical factors s uch as polarity, delusions, gender, onset, personality disorders, and famil y history of mood disorders did not influence the observed association. Our preliminary findings suggest that melancholic features may be associated w ith favorable lithium prophylactic outcome in mood disorders. (C) 2000 Wile y-Liss, Inc.