Response to electroconvulsive therapy in treatment-resistant depression: nationwide observational follow-up studyShow others and affiliations
2023 (English)In: BJPsych Open, E-ISSN 2056-4724, Vol. 9, no 2, article id e35Article in journal (Refereed) Published
Abstract [en]
BACKGROUND: Previous studies have not investigated response rates after electroconvulsive therapy (ECT) in patients with non-psychotic treatment-resistant depression (TRD).
AIMS: To assess and compare the response rate of ECT for patients with TRD and non-TRD, in a large and clinically representative patient sample.
METHOD: Patients aged ≥18 years, who were treated for a unipolar, non-psychotic depressive episode with at least one ECT session as part of a first-time, index ECT series between 1 January 2011 and 31 December 2017 were included from the Swedish National Quality Register for ECT. Patients who had initiated a third consecutive trial of antidepressants or add-on medications before start of ECT were classified as having TRD. Patients not meeting criteria for TRD were classified as non-TRD. The main outcome was response to ECT according to the Clinical Global Impressions - Improvement Scale (CGI-I), scored as 1 or 2 ('very much' or 'much improved' after ECT, respectively). Logistic regression was used to compare outcome measures between TRD and non-TRD, adjusting for potential confounders.
RESULTS: A total of 4244 patients were included. Of these, 1121 patients had TRD and 3123 patients had non-TRD. The CGI-I response rate was 65.9% in the TRD group compared with 75.9% in the non-TRD group (adjusted odds ratio 0.64, 95% CI 0.54-0.75). Older age and more severe depression were predictors of response in patients with TRD.
CONCLUSIONS: A clear majority of patients with TRD, as well as patients with non-TRD, responded to ECT, although the response rate was somewhat lower for TRD.
Place, publisher, year, edition, pages
Royal College of Psychiatrists , 2023. Vol. 9, no 2, article id e35
Keywords [en]
Depressive disorders, antidepressants, electroconvulsive therapy, epidemiology, outcome studies
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-104176DOI: 10.1192/bjo.2023.5ISI: 000934333300001PubMedID: 36786152Scopus ID: 2-s2.0-85148506800OAI: oai:DiVA.org:oru-104176DiVA, id: diva2:1736984
Funder
Swedish Research Council, 2016-02362Region StockholmKarolinska Institute, 5-63/2015
Note
Funding agencyies:
Stiftelsen Professor Bror Gadelius Minnesfond
Johnson & Johnson USA Janssen Biotech Inc 5-63/2015
2023-02-152023-02-152023-03-08Bibliographically approved