Self-assessed remission rates after electroconvulsive therapy of depressive disorders

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

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.

MeSH terms

  • Adult
  • Aged
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / therapy*
  • Electroconvulsive Therapy / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Self-Assessment*
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Antidepressive Agents