ABSTRACT
As lithium prophylaxis entered the mainstream of psychiatric treatment, the question of who responds and who does not became more and more important. This was especially so as the goal of prophylaxis is to prevent recurrences that are often difficult to anticipate because they can be separated by months or even years of spontaneous remissions. Yet, for clinical practice, it is relevant to identify as early as possible those who can benefit from the treatment and those who cannot. Among the clinical variables examined in this context was family history. Work of several research groups in the early 1970s suggested that patients with a family history of manic-depressive illness had significantly greater benefit from lithium than those with negative family histories1,2. Several subsequent studies agreed with these first
observations3-6. The consensus was not unanimous, however, and several papers either could not find any difference between responders and non-responders7,8, or found the opposite, that is subjects with a positive family history not responding as well9,10.
