Affordable Access

Publisher Website

Challenges in defining treatment-resistant mania in adults: A systematic review.

Authors
  • Gonzalez-Torres, Christina1, 2
  • Mulsant, Benoit H1, 2
  • Husain, M Ishrat1, 2
  • Alda, Martin3, 4
  • Young, Robert C5
  • Ortiz, Abigail1, 2
  • 1 Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. , (Canada)
  • 2 Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. , (Canada)
  • 3 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada. , (Canada)
  • 4 National Institute of Mental Health, Klecany, Czech Republic. , (Czechia)
  • 5 Department of Psychiatry, Weil Cornell Medicine, New York, New York, USA.
Type
Published Article
Journal
Bipolar Disorders
Publisher
Wiley (Blackwell Publishing)
Publication Date
Feb 01, 2024
Volume
26
Issue
1
Pages
7–21
Identifiers
DOI: 10.1111/bdi.13383
PMID: 37963496
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To review the definitions of treatment-resistant mania (TRM) in the literature and propose criteria for an operationalized definition. A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles. 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. 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. © 2023 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd.

Report this publication

Statistics

Seen <100 times