Study designs of evaluations included in the review
Chart reviews, case series, naturalistic trials, open trials and randomised controlled trials (RCTs) with at least 9 patients were eligible for inclusion.
Specific interventions included in the review
Studies that evaluated mood stabilisers, antiepileptics, antipsychotics or combinations of these medications were eligible for inclusion. The included studies evaluated mood-stabiliser monotherapy (divalproex (DVPX), lithium, lamotrigine, oxcarbazepine and topirimate), mood-stabiliser combination therapy (DVPX plus lithium), antipsychotic monotherapy (olanzapine, quetiapine, risperidone, aripiprazole and clozapine) and antipsychotics plus mood-stabiliser combination therapy (quetiapine plus DVPX, risperidone plus lithium, and risperidone plus DVPX). Most studies were short term (4 to 8 weeks); other studies were medium term (18 to 28 weeks) and only one was long term (up to 1 year).
Participants included in the review
Studies of paediatric patients who had been diagnosed with a bipolar spectrum disorder were eligible for inclusion. In the included studies, the mean age of the patients was 12.3 years; most studies included patients aged 4 to 20 years but some only included adolescents or pre-school-aged children. In most studies patients had manic or mixed symptomatology.
Outcomes assessed in the review
Studies that assessed changes in body composition, glucose or lipid values were eligible for inclusion. Studies had to report numeric values for their measure of ‘weight gain’.
How were decisions on the relevance of primary studies made?
The author did not state how the papers were selected for the review, or how many reviewers performed the selection.