{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:42:29Z","timestamp":1777444949885,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study examines the association between the coefficient of variation (%CV) of lithium levels and episode risk and frequency in bipolar patients maintaining serum lithium levels within the therapeutic range.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients with bipolar disorder under care from 2018 to 2022. Inclusion criteria were at least 2\u00a0years of follow-up, a minimum of three annual lithium level measurements within the therapeutic range. Patients were categorized based on seizure status. We calculated mean lithium levels, standard deviation (SD), and %CV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 75 patients (patients with-without episodes, 39\u201336). Demographic data revealed no significant differences. While mean lithium levels showed no significant disparity between groups, SD and %CV were notably higher in patients with episodes ( P &lt; .05). ROC analysis demonstrated AUC values of 0.722 (95% CI: 0.607\u20130.836 P = .001) for %CV and 0.709 (95% CI: 0.593\u20130.826; P = .002) for SD. The optimal %CV cutoff was 17.39, with 67% sensitivity and 69% specificity. A weak correlation was found between %CV and the number of episodes ( P = .001, r = 0.376). The post-hoc power analysis for this study was 0.78.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite acceptable lithium levels, patients with recent episodes exhibited significant lithium level fluctuations. Integrating %CV with real-time lithium measurements during bipolar disorder follow-up may enhance clinical monitoring and seizure prediction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00045632241262873","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T01:52:30Z","timestamp":1717638750000},"page":"446-450","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of lithium variation coefficient on the risk of attack in patients with bipolar disorder: A pilot study"],"prefix":"10.1177","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3427-9893","authenticated-orcid":false,"given":"Saniye","family":"Ba\u015fak Oktay","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u015eeyma","family":"Sehliko\u011flu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sevler","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Clinic of Psychiatry, Elaz\u0131\u011f Fethi Sekin C\u0131ty Hosp\u0131tal, Elaz\u0131\u011f, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behice","family":"Han Almi\u015f","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0130smail G\u00fcrkan","family":"\u00c7ikim","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Adiyaman University, Adiyaman, 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