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BMC Psychiatry. 2016 Nov 11;16(1):396.

A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?

Author information

1
Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento - RS - Brazil, 2350, Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil. lucaspcalves@gmail.com.
2
Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento - RS - Brazil, 2350, Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil.
3
Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Hospital de Clínicas de Porto Alegre-RS-Brazil, 2350, Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil.
4
Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento - RS -Brazil, 2350, Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil.

Abstract

BACKGROUND:

Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT.

METHODS:

Depressed adults according to MINI admitted in a psychiatric unit were divided in unilateral ECT treated and non-ECT treated. Main outcomes were: depression improvement in Hamilton Rating Scale for Depression (HDRS-17) scores; response (HDRS-17 improvement ≥50 %); remission (HDRS-17 score ≤7); length of hospitalization.

RESULTS:

Forty-three patients were included in unilateral ECT group and 104 in non-ECT group. No differences of psychotic symptoms, melancholic features or past maniac episode were found between groups. Unilateral ECT group had a mean HDRS-17 score higher than non-ECT group at admission (ECT: 25.05 ± 1.03; non-ECT: 21.61 ± 0.69; p = 0.001), but no significant difference was found at discharge (ECT: 7.70 ± 0.81; non-ECT: 7.40 ± 0.51; p = 0.75). Unilateral ECT group had a larger HDRS-17 score reduction during treatment (ECT: 18.24 ± 1.18; non-ECT:14.20 ± 0.76; p = 0.004). There were no significant differences in response and remission rates between groups. Unilateral ECT group had longer mean duration of hospitalization in days (ECT: 35.48 ± 2.48; non-ECT: 24.57 ± 1.50; p < 0.001), but there were no difference in mean time of treatment (ECT group:27.66 ± 1.95; non-ECT: 24.57 ± 1.50; p = 0.25).

CONCLUSIONS:

Unilateral high-dose ECT is still a useful treatment option, in the real world clinical practice, to reduce the intensity of depressive symptoms in highly depressed inpatients.

KEYWORDS:

Depressive disorder; Electroconvulsive therapy; Naturalistic Study; Pragmatic Clinical Trials as Topic

PMID:
27836011
PMCID:
PMC5106807
DOI:
10.1186/s12888-016-1095-z
[Indexed for MEDLINE]
Free PMC Article

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