Attitudes towards pharmacotherapy in late-life bipolar disorder
Bibliographic record
Abstract
BACKGROUND: Lithium remains a first-line treatment for bipolar disorder, but clinicians have considerable concern over potential adverse effects, especially in older adults. Older patients' attitude towards lithium has not been investigated, even though negative attitudes are closely associated with reduced adherence. We examine the attitude towards lithium pharmacotherapy in older adults with bipolar disorder. METHODS: In a cross-sectional study of 78 patients aged >60 years with bipolar disorder, the association between lithium use and attitudes towards psychotropic pharmacotherapy was assessed using the Drug Attitude Inventory (DAI-10), including multivariate analyses. RESULTS: Compared to patients using alternative psychopharmacological treatments (n =30), lithium users (n=48) showed higher self-reported contentedness, subjective somatic health, and social functioning scores. Although 58.7% of lithium users reported severe adverse effects, lithium users had more positive attitudes towards psychotropic pharmacotherapy compared to non-users (DAI-10 mean score 6.0 vs. 3.9, p =0.01), and this effect was independent of potential confounders. CONCLUSIONS: Older bipolar patients using lithium have a more positive attitude towards psychotropic pharmacotherapy, despite high rates of adverse effects. Future longitudinal studies could investigate whether positive medication attitudes lead to improved treatment adherence and reduced bipolar disorder relapse in older lithium users.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".