Table 3.
The CINP definitions of response, remission, recovery, and resistance for BD
| Phase | Scale scores | Treatment duration according to CINP guidelines | |
|---|---|---|---|
| Response | Acute mania | <25%, 25–49%, 50–74%, 75–100% reduction in YMRS or MRS scores No significant increase in MADRS or HDRS scores and MADRS and HDRS scores stay below 6 | 8–10 weeks |
| Acute Bipolar depression | <25%, 25–49%, 50–74%, 75–100% reduction in MADRS or HDRS scores No significant increase in YMRS or MRS scores and YMRS and MRS scores stay below 5 | 10–12 weeks | |
| Maintenance | Significant change in the frequency of episodes | 1 year | |
| Remission | Acute mania | YMRS and MRS scores stay below 5 No significant increase in MADRS or HDRS scores and MADRS and HDRS scores stay below 6 | 8 weeks |
| Acute Bipolar depression | MADRS and HDRS scores stay below 6 No significant increase in YMRS or MRS scores and YMRS and MRS scores stay below 5 | 8 weeks | |
| Maintenance | Very rare new episodes, and MADRS/HDRS scores <6 and YMRS/MRS scores <7 between episodes | 2–3 years? | |
| Recovery | Acute mania | YMRS and MRS scores stay below 5 No significant increase in MADRS or HDRS scores and MADRS and HDRS scores stay below 6 | 8 weeks |
| Acute Bipolar depression | MADRS and HDRS scores stay below 6 No significant increase in YMRS or MRS scores and YMRS and MRS scores stay below 5 | 8 weeks | |
| Maintenance | No new mood episodes and MADRS/HDRS scores <6 and YMRS/MRS scores <7 between episodes | 3–5 years | |
| Resistance | Acute mania | No significant reduction in YMRS or MRS scores, or significant increase in MADRS or HDRS scores or MADRS and HDRS scores exceed 6 | 8–10 weeks |
| Acute Bipolar depression | No significant reduction in in MADRS or HDRS scores or significant increase in YMRS or MRS scores or YMRS and MRS scores exceed 5 | 10–12 weeks | |
| Maintenance | No change in the frequency of episodes, or MADRS/HDRS scores >6 or YMRS/MRS scores >7 between episodes | 1 year |
Abbreviations: BD, bipolar disorder; HDRS, Hamilton Depression Rating Scale; MADRS, Mondgomery-Asberg Depression Rating Scale; MRS, Mania Rating Scale; YMRS, Young Mania Rating Scale.