Faculty Opinions recommendation of Electroconvulsive therapy and risk of dementia in patients with affective disorders: a cohort study.

Objectives. Electroconvulsive therapy (ECT) is an effective treatment for severe depression. Electroencephalogram (EEG) measures between ECT sessions seem to be related to the antidepressant efficacy of ECT. In this naturalistic cohort study, we examine longitudinal effects of ECT on interhemispheric EEG coherence measures during seizure activity and its relation to the antidepressant efficacy. Methods. This study included 65 patients diagnosed with severe depressive disorder. Depressive symptoms were rated according to the Montgomery-Åsberg Depression Rating Scale before and after the course of ECT. Frequency-specific ictal interhemispheric (fp1-fp2) EEG coherence measures were established during the first and each consecutive sixth treatment session. Linear mixed-effect models were used to determine longitudinal changes in ictal coherence measures during the course of ECT and its relation to treatment efficacy. Results. Ictal interhemispheric coherence in the theta and alpha frequency bands increased over the course of treatment, whereas no significant change was found for the delta and beta frequency bands. A main effect of treatment efficacy on the interhemispheric coherence in the delta and theta band was revealed. However, the longitudinal effects of ECT were not associated with treatment efficacy. Conclusion. The current study suggests that interhemispheric coherence during ECT-induced seizures increases over the course of treatment. Furthermore, these longitudinal effects seem to be unrelated to the antidepressant efficacy of ECT. These findings contribute to the understanding of the mechanism of action of ECT.

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Long-Term Risk of Developing Dementia After Electroconvulsive Therapy for Affective Disorders

Journal of Ect ◽

10.1097/yct.0000000000000770 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Simon Hjerrild ◽

Johnny Kahlert ◽

Poul-Erik Buchholtz ◽

Raben Rosenberg ◽

Poul Videbech

Keyword(s):

Electroconvulsive Therapy ◽

Affective Disorders

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MAINTENANCE ELECTROCONVULSIVE THERAPY IN AFFECTIVE DISORDERS

Past, Present and Future of Psychiatry ◽

10.1142/9789814440912_0079 ◽

1994 ◽

Author(s):

G. N. PAPADIMITRIOU ◽

Y. G. PAPAKOSTAS ◽

I. M. ZERVAS ◽

C. N. STEFANIS

Keyword(s):

Electroconvulsive Therapy ◽

Affective Disorders

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Is cesarean section a cause of affective disorders?—A national cohort study using sibling designs

Journal of Affective Disorders ◽

10.1016/j.jad.2020.01.046 ◽

2020 ◽

Vol 265 ◽

pp. 496-504 ◽

Cited By ~ 1

Author(s):

Paul Bryde Axelsson ◽

Anne Helby Petersen ◽

Ida Hageman ◽

Anja Bisgaard Pinborg ◽

Lars Vedel Kessing ◽

...

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Affective Disorders ◽

National Cohort

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Increased risk of affective disorders in type 2 diabetes is minimized by sulfonylurea and metformin combination: a population-based cohort study

BMC Medicine ◽

10.1186/1741-7015-10-150 ◽

2012 ◽

Vol 10 (1) ◽

Cited By ~ 26

Author(s):

Mark L Wahlqvist ◽

Meei-Shyuan Lee ◽

Shao-Yuan Chuang ◽

Chih-Cheng Hsu ◽

Hsin-Ni Tsai ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Affective Disorders ◽

Population Based ◽

Increased Risk

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Maintenance Electroconvulsive Therapy and hospital re-admission days among patients with mental illness in Malaysia

10.1101/2020.09.20.20197079 ◽

2020 ◽

Author(s):

Benedict Francis ◽

Yit Han Ng ◽

Julian Joon Ip Wong ◽

Shiau Thin Ling ◽

Jesjeet Singh Gill ◽

...

Keyword(s):

Mental Illness ◽

Electroconvulsive Therapy ◽

Treatment Modality ◽

Affective Disorders ◽

Chart Review ◽

Retrospective Chart Review ◽

National Data ◽

Schizophrenia Spectrum ◽

Maintenance Ect ◽

Review Study

Abstract Background : Relapse prevention strategies are important as part of optimal patient care. As such, maintenance electroconvulsive therapy (mECT) is an important treatment modality to keep patients in remission longer. Aims : Our study aimed to explore the characteristics of patients receiving maintenance ECT (mECT) and further investigate whether this treatment modality reduces re-admission days in patients with severe mental illness. Methods : A retrospective chart review study design was employed. The medical records of 22 patients followed up at University Malaya Medical centre, were analysed with regards to the outcome measures, which was days of re-admission post mECT, Potential confounders were controlled for via stratification analysis. Results : There was a significant reduction in re-admission days post mECT (p<0.001, r:0.85 ) across all the variables analysed. The variable with the biggest effect size were patients younger than 60 years old (p:0.01, r:0.70), followed by medication with polypharmacy (p:0.002, r: 0.65). The magnitude of reduction in re-admissions was greater in the schizophrenia spectrum group compared to the affective disorders group (r: 0.64 vs. 0.57). Conclusion : Our study provides national data regarding the efficacy of mECT in significantly reducing days of re-admission in patients with treatment resistant schizophrenia spectrum illness and affective disorders. As widespread usage of mECT is still lacking in Asia, our results is encouraging for more practitioners to prescribe mECT for their patients.

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The effect of anaesthetic dose on response and remission in electroconvulsive therapy for major depressive disorder: nationwide register-based cohort study

BJPsych Open ◽

10.1192/bjo.2021.31 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Alexander Kronsell ◽

Axel Nordenskjöld ◽

Max Bell ◽

Ridwanul Amin ◽

Ellenor Mittendorfer-Rutz ◽

...

Keyword(s):

Major Depressive Disorder ◽

Cohort Study ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Treatment Effect ◽

Odds Ratio ◽

High Dose ◽

Major Depressive ◽

Remission Rates ◽

Deep Anaesthesia

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.

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