Predictors of regained occupational functioning after electroconvulsive therapy (ECT) in patients with major depressive disorder—A population based cohort study

Background Electroconvulsive therapy (ECT) is a safe and effective treatment for major depressive disorder (MDD). ECT treatment effect relies on induced generalised seizures. Most anaesthetics raise the seizure threshold and shorten seizure duration. There are no conclusive studies on the effect of anaesthetic dose on response and remission rates with ECT for MDD. Aims We aimed to examine the effect of different dose intervals of anaesthetics on response and remission after ECT for MDD. Method We conducted a nationwide cohort study, using data from Swedish registers. Low-, medium- and high-dose intervals, adjusted for age and gender, were constructed for each anaesthetic drug. Response and remission were measured with the Clinical Global Impression – Severity and Improvement scales (CGI-I and CGI-S), and a self-rated version of the Montgomery–Åsberg Depression Rating Scale (MADRS-S). Logistic regression models were used to calculate adjusted odds ratios for response and remission rates. Results The study included 7917 patients who received ECT for MDD during 2012–2018. Patients were given either thiopental (64.1%) or propofol (35.9%). Low-dose intervals of anaesthetics were associated with increased rates of response (CGI-I: odds ratio 1.22, 95% CI 1.07–1.40, P = 0.004; MADRS-S: odds ratio 1.31, 95% CI 1.09–1.56, P = 0.004) and remission (CGI-S: odds ratio 1.37, 95% CI 1.17–1.60, P ≤ 0.001; MADRS-S: odds ratio 1.31, 95% CI 1.10–1.54, P = 0.002). Conclusions We found improved treatment outcomes with low- compared with high-dose anaesthetic during ECT for MDD. To enhance treatment effect, deep anaesthesia during ECT for MDD should be avoided.

Download Full-text

Newly diagnosed major depressive disorder and the risk of erectile dysfunction: A population-based cohort study in Taiwan

Psychiatry Research ◽

10.1016/j.psychres.2013.06.012 ◽

2013 ◽

Vol 210 (2) ◽

pp. 601-606 ◽

Cited By ~ 13

Author(s):

Shiau-Shian Huang ◽

Ching-Heng Lin ◽

Chin-Hong Chan ◽

El-Wui Loh ◽

Tsuo-Hung Lan

Keyword(s):

Major Depressive Disorder ◽

Cohort Study ◽

Erectile Dysfunction ◽

Depressive Disorder ◽

Population Based ◽

Newly Diagnosed ◽

Major Depressive

Download Full-text

Predictors of Time to Relapse/Recurrence after Electroconvulsive Therapy in Patients with Major Depressive Disorder: A Population-Based Cohort Study

Depression Research and Treatment ◽

10.1155/2011/470985 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Axel Nordenskjöld ◽

Lars von Knorring ◽

Ingemar Engström

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Substance Dependence ◽

Population Based ◽

Major Depressive ◽

Quality Register ◽

Increased Risk ◽

One Year ◽

Risk Of Relapse

Objective. The aim of the study is to define predictors of relapse/recurrence after electroconvulsive therapy, ECT, for patients with major depressive disorder.Methods. A study of all patients (n=486) treated by means of ECT for major depressive disorder was performed. The data were derived from a regional quality register in Sweden. Psychiatric hospitalisation or suicide was used as a marker for relapse/recurrence.Results. The relapse/recurrence rate within one year after ECT was 34%. Factors associated with increased risk of relapse/recurrence included comorbid substance dependence and treatment with benzodiazepines or antipsychotics during the follow-up period.Conclusions. Within the first years after ECT, relapses/recurrences leading to hospitalisation or suicide are common. Treatment with lithium might be beneficial, while benzodiazepines, antipsychotics, or continuation ECT does not seem to significantly reduce the risk of relapse/recurrence.

Download Full-text