Teaching patients with bipolar disorder to identify early symptoms of relapse

BMJ 1999;318:1557 ( 5 June )

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Teaching patients with bipolar disorder to identify early symptoms of relapse

When were outcomes separated?

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When were outcomes separated?

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EDITOR $---$ The decision to analyse the relapses for mania and depression separately in Perry et al's trial in patients with bipolardisorder is crucial.¹ The reported power analysis was calculatedfor the overall (mania and depression) relapse rate, but no resultis shown relating to the overall relapse rate. This raises thepossibility that the decision to split the outcomes was takenlater.

The authors explain why the decision was taken: they considered that the experimental and control treatments differed qualitativelyfor mania and depression. But did the data in the study influencethe decision to split the outcomes? If separate analysis of thetwo outcomes was specified in advance in the study protocol theauthors' conclusions are justified. If it was not then the distinctionbetween the different effects on manic and depressive relapserates becomes an interesting observation that merits further study.Could the timing of the . . . [Full text of this article]

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Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment: Alison Perry, Nicholas Tarrier, Richard Morriss, Eilis McCarthy, and Kate Limb
BMJ 1999 318: 149-153. [Abstract] [Full Text] [PDF]