The effect of lithium variation coefficient on the risk of attack in patients with bipolar disorder: A pilot study

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dc.contributor.authorOktay, Saniye Basak
dc.contributor.authorSehlikoglu, Seyma
dc.contributor.authorYildiz, Sevler
dc.contributor.authorAlmis, Behice Han
dc.contributor.authorCikim, Ismail Gurkan
dc.date.accessioned2026-01-24T12:29:05Z
dc.date.available2026-01-24T12:29:05Z
dc.date.issued2024
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractBackground: 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. Methods: We retrospectively reviewed patients with bipolar disorder under care from 2018 to 2022. Inclusion criteria were at least 2 years 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. Results: The study included 75 patients (patients with-without episodes, 39-36). 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 < .05). ROC analysis demonstrated AUC values of 0.722 (95% CI: 0.607-0.836 P = .001) for %CV and 0.709 (95% CI: 0.593-0.826; 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. Conclusions: 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.
dc.identifier.doi10.1177/00045632241262873
dc.identifier.endpage450
dc.identifier.issn0004-5632
dc.identifier.issn1758-1001
dc.identifier.issue6
dc.identifier.pmid38840473
dc.identifier.scopus2-s2.0-85196631904
dc.identifier.scopusqualityQ2
dc.identifier.startpage446
dc.identifier.urihttps://doi.org/10.1177/00045632241262873
dc.identifier.urihttps://hdl.handle.net/20.500.12868/5120
dc.identifier.volume61
dc.identifier.wosWOS:001251594300001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSage Publications Inc
dc.relation.ispartofAnnals of Clinical Biochemistry
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20260121
dc.subjectBipolar disorder
dc.subjectlithium
dc.subjectcoefficient of variation
dc.titleThe effect of lithium variation coefficient on the risk of attack in patients with bipolar disorder: A pilot study
dc.typeArticle

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