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Diagnosis and Lithium Carbonate Response in Psychotic Patients

David L. Garver, MD; Robert Hitzemann, PhD; Jack Hirschowitz, MD

Arch Gen Psychiatry. 1984;41(5):497-505.

Abstract
• The distribution of RBC lithium ratios in vitro in a recently hospitalized psychiatric population was found to be multimodal. Psychotic patients who had an antipsychotic response during open trials of lithium carbonate alone were identified with high sensitivity (89%), but low specificity (51%) before drug treatment, by lithium ratios that were in the extreme modes of the distribution (<0.30 or >0.38). Diagnostic efficiency of the test was 61%. The DSM-III diagnosis of schizophreniform disorder demonstrated 90% diagnostic efficiency in predicting response/nonresponse during treatment with lithium carbonate alone. A subgroup of the psychotic disorders was similar to affective disorders with respect to course of illness, biological characteristics, and response to lithium carbonate.

Author Affiliations
From the Departments of Psychiatry (Drs Garver, Hitzemann, and Hirschowitz) and Pharmacology and Cell Biophysics (Drs Garver and Hitzemann), University of Cincinnati College of Medicine.

Footnotes
Accepted for publication Sept 19, 1983.

Reprint requests to Department of Psychiatry, Mail Location 59, University of Cincinnati College of Medicine, 231 Bethesda Ave, Cincinnati, OH 45267 (Dr Garver).

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