{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:18:15Z","timestamp":1789841895020,"version":"4.0.1"},"reference-count":13,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017225","name":"Aretaeus Foundation of Rome","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Time to a new episode of bipolar disorder (BD) is shorter after discontinuing lithium rapidly. We now address this and other factors associated with the risk of early illness after discontinuing lithium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared factors for association with recurrences of BD within 12\u00a0months of discontinuing long\u2010term lithium treatment, using bivariate and multivariable analyses, as well as survival analysis to evaluate latency to new episodes versus rate of lithium\u2010discontinuation and prior treatment duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 227 BD subjects who received lithium for 4.47 [CI: 3.89\u20135.04] years and then discontinued, rapid treatment\u2010discontinuation, and stopping for medical reasons were strongly associated with new illness\u2010episodes within 12\u00a0months, as were diagnosis (BD\u2010I\u2009&gt;\u2009BD\u2010II), greater morbidity during lithium\u2010treatment, and less education, but neither longer treatment nor serum lithium concentrations. Discontinuation rate was strongly associated with shorter median latency to a new episode (rapid: 3.50; gradual [\u22652\u2009weeks]: 10.6\u2009months), even with very early recurrences excluded to avoid potential contributions of emerging illness to treatment\u2010discontinuation. Early recurrence was not associated with treatment\u2010duration of \u22652 or \u22655\u2009years or less. In multivariable logistic regression, rapid discontinuation, stopping for medical reasons, and BD\u2010I diagnosis remained significantly, independently associated with early illness after lithium\u2010discontinuation, with no effect of treatment duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early recurrence risk was again much greater after rapid discontinuation of lithium and discontinuing for medical reasons, somewhat greater with BD\u2010I than BD\u2010II, and following greater morbidity during lithium\u2010treatment, but not related to dose or duration of preceding treatment exposure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.13206","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T14:08:36Z","timestamp":1648044516000},"page":"720-725","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Risk factors for early recurrence after discontinuing lithium in bipolar disorder"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9718-8211","authenticated-orcid":false,"given":"Ross J.","family":"Baldessarini","sequence":"first","affiliation":[{"name":"International Consortium for Mood &amp; Psychotic Disorder Research McLean Hospital  Belmont Massachusetts USA"},{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pinna","sequence":"additional","affiliation":[{"name":"Lucio Bini Mood Disorder Centers Cagliari &amp; Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Contu","sequence":"additional","affiliation":[{"name":"Lucio Bini Mood Disorder Centers Cagliari &amp; Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo H.","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"International Consortium for Mood &amp; Psychotic Disorder Research McLean Hospital  Belmont Massachusetts USA"},{"name":"Department of Psychiatry Queen's University School of Medicine  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Tondo","sequence":"additional","affiliation":[{"name":"International Consortium for Mood &amp; Psychotic Disorder Research McLean Hospital  Belmont Massachusetts USA"},{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Lucio Bini Mood Disorder Centers Cagliari &amp; Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000506868"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2007.00389.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000497334"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.13017"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.06101639"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1993.01820180046005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.4.551"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1997.01830130055011"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.09060880"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2018.17091001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291720004778"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12105"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045125314540297"}],"container-title":["Bipolar Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.13206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bdi.13206","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bdi.13206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T14:37:27Z","timestamp":1692628647000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bdi.13206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/bdi.13206"],"URL":"https:\/\/doi.org\/10.1111\/bdi.13206","archive":["Portico"],"relation":{},"ISSN":["1398-5647","1399-5618"],"issn-type":[{"value":"1398-5647","type":"print"},{"value":"1399-5618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,5]]},"assertion":[{"value":"2022-04-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}