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Eur Psychiatry. 2017 Sep;45:154-160. doi: 10.1016/j.eurpsy.2017.06.015. Epub 2017 Jul 21.

Self-assessed remission rates after electroconvulsive therapy of depressive disorders.

Author information

1
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden. Electronic address: ole.brus@regionorebrolan.se.
2
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
3
Department of Psychiatry, Umeå University Hospital, Umeå, Sweden.
4
Psychiatric Neuromodulation Unit (PNU), Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.
5
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
6
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
7
Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of Psychiatry, Region Östergötland, Linköping, Sweden.
8
School of Medical Sciences, Örebro University, Örebro, Sweden.

Abstract

BACKGROUND:

Electroconvulsive therapy (ECT) effectively treats severe depression, but not all patients remit. The aim of the study was to identify clinical factors that associate with ECT-induced remission in a community setting.

METHODS:

Depressed patients who underwent ECT in 2011-2014 were identified from the Swedish National Quality Register for ECT. Remission was defined as self-rated Montgomery-Åsberg Depression Rating Scale scores of 0-10 after ECT. Other registers provided data on previous antidepressant use, comorbidities, and demographics.

RESULTS:

Of 1671 patients fulfilling the inclusion criteria, 42.8% achieved remission. Older age, education length over 9 years, psychotic symptoms, shorter duration of preceding antidepressant use, pulse width stimulus≥0.50ms, absence of substance use disorders, anxiety diagnosis, lamotrigine, and benzodiazepines, were associated with remission.

CONCLUSIONS:

This study shows that psychotic subtype of depression and older age are clinically relevant predictors of a beneficial ECT effect. Additionally, ECT outcomes can be further improved by optimizing the treatment technique and concomitant medication.

KEYWORDS:

ECT; Mania and bipolar disorder; Unipolar depression

PMID:
28865389
DOI:
10.1016/j.eurpsy.2017.06.015
[Indexed for MEDLINE]
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