Challenges in defining treatment‐resistant mania in adults: A systematic review
Objectives To review the definitions of treatment‐resistant mania (TRM) in the literature and propose criteria for an operationalized definition. Methods A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles. Results...
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| Veröffentlicht in: | Bipolar disorders 2024-02, Vol.26 (1), p.7-21 |
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| creator | Gonzalez‐Torres, Christina Mulsant, Benoit H. Husain, M. Ishrat Alda, Martin Young, Robert C. Ortiz, Abigail |
| description | Objectives
To review the definitions of treatment‐resistant mania (TRM) in the literature and propose criteria for an operationalized definition.
Methods
A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles.
Results
In total, 47 articles addressing the concept of TRM were included, comprising 16 case reports, 11 case series, 3 randomized clinical trials, 8 open‐label clinical trials, 1 experimental study, 7 narrative reviews, and 1 systematic review. While reviews discussed several challenges in defining TRM, definitions varied substantially based on different criteria for severity of mania, duration of mania, and use of specific therapeutic agents with minimal dosages and duration of treatment. Only a handful of the reviewed articles operationalized these criteria.
Conclusion
While the concept of TRM has been discussed in the literature for over three decades, we could not find an agreed‐upon operationalized definition based on specific criteria. We propose and discuss a possible definition that could be used by clinicians to guide their practice and by researchers to assess the prevalence of TRM and develop and test interventions targeting TRM. |
| doi_str_mv | 10.1111/bdi.13383 |
| format | Article |
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To review the definitions of treatment‐resistant mania (TRM) in the literature and propose criteria for an operationalized definition.
Methods
A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles.
Results
In total, 47 articles addressing the concept of TRM were included, comprising 16 case reports, 11 case series, 3 randomized clinical trials, 8 open‐label clinical trials, 1 experimental study, 7 narrative reviews, and 1 systematic review. While reviews discussed several challenges in defining TRM, definitions varied substantially based on different criteria for severity of mania, duration of mania, and use of specific therapeutic agents with minimal dosages and duration of treatment. Only a handful of the reviewed articles operationalized these criteria.
Conclusion
While the concept of TRM has been discussed in the literature for over three decades, we could not find an agreed‐upon operationalized definition based on specific criteria. We propose and discuss a possible definition that could be used by clinicians to guide their practice and by researchers to assess the prevalence of TRM and develop and test interventions targeting TRM.</description><identifier>ISSN: 1398-5647</identifier><identifier>ISSN: 1399-5618</identifier><identifier>EISSN: 1399-5618</identifier><identifier>DOI: 10.1111/bdi.13383</identifier><identifier>PMID: 37963496</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Affective disorders ; bipolar disorder ; Case reports ; Clinical trials ; mania ; pharmacotherapy ; psychopharmacology ; Reviews ; Systematic review ; treatment refractory ; treatment resistance</subject><ispartof>Bipolar disorders, 2024-02, Vol.26 (1), p.7-21</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2023 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3483-4b5a127962a1039b861bb2870bfc7fc217fc20e502569aaebbe85959a22668483</cites><orcidid>0000-0001-5771-5750 ; 0000-0001-9544-3944 ; 0000-0001-6886-767X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbdi.13383$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbdi.13383$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37963496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gonzalez‐Torres, Christina</creatorcontrib><creatorcontrib>Mulsant, Benoit H.</creatorcontrib><creatorcontrib>Husain, M. Ishrat</creatorcontrib><creatorcontrib>Alda, Martin</creatorcontrib><creatorcontrib>Young, Robert C.</creatorcontrib><creatorcontrib>Ortiz, Abigail</creatorcontrib><title>Challenges in defining treatment‐resistant mania in adults: A systematic review</title><title>Bipolar disorders</title><addtitle>Bipolar Disord</addtitle><description>Objectives
To review the definitions of treatment‐resistant mania (TRM) in the literature and propose criteria for an operationalized definition.
Methods
A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles.
Results
In total, 47 articles addressing the concept of TRM were included, comprising 16 case reports, 11 case series, 3 randomized clinical trials, 8 open‐label clinical trials, 1 experimental study, 7 narrative reviews, and 1 systematic review. While reviews discussed several challenges in defining TRM, definitions varied substantially based on different criteria for severity of mania, duration of mania, and use of specific therapeutic agents with minimal dosages and duration of treatment. Only a handful of the reviewed articles operationalized these criteria.
Conclusion
While the concept of TRM has been discussed in the literature for over three decades, we could not find an agreed‐upon operationalized definition based on specific criteria. We propose and discuss a possible definition that could be used by clinicians to guide their practice and by researchers to assess the prevalence of TRM and develop and test interventions targeting TRM.</description><subject>Affective disorders</subject><subject>bipolar disorder</subject><subject>Case reports</subject><subject>Clinical trials</subject><subject>mania</subject><subject>pharmacotherapy</subject><subject>psychopharmacology</subject><subject>Reviews</subject><subject>Systematic review</subject><subject>treatment refractory</subject><subject>treatment resistance</subject><issn>1398-5647</issn><issn>1399-5618</issn><issn>1399-5618</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kMtKAzEUhoMoXqoLX0AG3OiibS6dTOKu1isIIug6JNMzmjKT1iRj6c5H8Bl9EtNWXQiexTn_4uPj8CN0SHCPpOmbse0RxgTbQLuESdnNORGbqyxSHhQ7aC-ECcaEU5xvox1WSM4Gku-ih9GLrmtwzxAy67IxVNZZ95xFDzo24OLn-4eHYEPULmaNdlYvOT1u6xjOsmEWFiFCo6MtMw9vFub7aKvSdYCD79tBT1eXj6Ob7t399e1oeNct2UCw7sDkmtD0B9UEM2kEJ8ZQUWBTlUVVUrJcGHJMcy61BmNA5DKXmlLORTJ00MnaO_PT1xZCVI0NJdS1djBtg6JCYsYpxTKhx3_QybT1Ln2nqKSsEJIltoNO11TppyF4qNTM20b7hSJYLXtWqWe16jmxR9_G1jQw_iV_ik1Afw3MbQ2L_03q_OJ2rfwCXmOGiA</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Gonzalez‐Torres, Christina</creator><creator>Mulsant, Benoit H.</creator><creator>Husain, M. Ishrat</creator><creator>Alda, Martin</creator><creator>Young, Robert C.</creator><creator>Ortiz, Abigail</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5771-5750</orcidid><orcidid>https://orcid.org/0000-0001-9544-3944</orcidid><orcidid>https://orcid.org/0000-0001-6886-767X</orcidid></search><sort><creationdate>202402</creationdate><title>Challenges in defining treatment‐resistant mania in adults: A systematic review</title><author>Gonzalez‐Torres, Christina ; Mulsant, Benoit H. ; Husain, M. Ishrat ; Alda, Martin ; Young, Robert C. ; Ortiz, Abigail</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3483-4b5a127962a1039b861bb2870bfc7fc217fc20e502569aaebbe85959a22668483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Affective disorders</topic><topic>bipolar disorder</topic><topic>Case reports</topic><topic>Clinical trials</topic><topic>mania</topic><topic>pharmacotherapy</topic><topic>psychopharmacology</topic><topic>Reviews</topic><topic>Systematic review</topic><topic>treatment refractory</topic><topic>treatment resistance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonzalez‐Torres, Christina</creatorcontrib><creatorcontrib>Mulsant, Benoit H.</creatorcontrib><creatorcontrib>Husain, M. Ishrat</creatorcontrib><creatorcontrib>Alda, Martin</creatorcontrib><creatorcontrib>Young, Robert C.</creatorcontrib><creatorcontrib>Ortiz, Abigail</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Bipolar disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonzalez‐Torres, Christina</au><au>Mulsant, Benoit H.</au><au>Husain, M. Ishrat</au><au>Alda, Martin</au><au>Young, Robert C.</au><au>Ortiz, Abigail</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Challenges in defining treatment‐resistant mania in adults: A systematic review</atitle><jtitle>Bipolar disorders</jtitle><addtitle>Bipolar Disord</addtitle><date>2024-02</date><risdate>2024</risdate><volume>26</volume><issue>1</issue><spage>7</spage><epage>21</epage><pages>7-21</pages><issn>1398-5647</issn><issn>1399-5618</issn><eissn>1399-5618</eissn><abstract>Objectives
To review the definitions of treatment‐resistant mania (TRM) in the literature and propose criteria for an operationalized definition.
Methods
A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles.
Results
In total, 47 articles addressing the concept of TRM were included, comprising 16 case reports, 11 case series, 3 randomized clinical trials, 8 open‐label clinical trials, 1 experimental study, 7 narrative reviews, and 1 systematic review. While reviews discussed several challenges in defining TRM, definitions varied substantially based on different criteria for severity of mania, duration of mania, and use of specific therapeutic agents with minimal dosages and duration of treatment. Only a handful of the reviewed articles operationalized these criteria.
Conclusion
While the concept of TRM has been discussed in the literature for over three decades, we could not find an agreed‐upon operationalized definition based on specific criteria. We propose and discuss a possible definition that could be used by clinicians to guide their practice and by researchers to assess the prevalence of TRM and develop and test interventions targeting TRM.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37963496</pmid><doi>10.1111/bdi.13383</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-5771-5750</orcidid><orcidid>https://orcid.org/0000-0001-9544-3944</orcidid><orcidid>https://orcid.org/0000-0001-6886-767X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Bipolar disorders, 2024-02, Vol.26 (1), p.7-21 |
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| language | eng |
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| source | MEDLINE; Wiley Journals |
| subjects | Affective disorders bipolar disorder Case reports Clinical trials mania pharmacotherapy psychopharmacology Reviews Systematic review treatment refractory treatment resistance |
| title | Challenges in defining treatment‐resistant mania in adults: A systematic review |
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