Appropriateness for electroconvulsive therapy (ECT) can be assessed on a three-item scale

Kellner, Charles H.; Popeo, Dennis M.; Pasculli, Rosa M.; Briggs, Mimi C.; Gamss, Stephen

doi:10.1016/j.mehy.2012.04.036

Cited by 22 publications

(11 citation statements)

References 22 publications

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“…In severe cases, the method is considered superior to pharmacotherapy [23]. The response rate seems to be higher if biological aspects of the illness prevail, as for example familiarity, well-delimitable phases or melancholic characteristics [24]. However, there are also reports on successful treatment in patients who do not comply with these requirements.…”

Section: Indication and Efficacymentioning

confidence: 99%

On the significance of elektroconvulsive therapy in the treatment of severe mental diseases

Grözinger

Smith

Conca

2015

Wien Klin Wochenschr

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Section: Indication and Efficacymentioning

confidence: 99%

On the significance of elektroconvulsive therapy in the treatment of severe mental diseases

Grözinger

Smith

Conca

2015

Wien Klin Wochenschr

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“…Kellner et al. (2012) identified three factors that the view as predicting benefit from ECT: severity of depressive symptoms, heritability of depression, and episodic nature of the depression and used these characteristics as the basis for an “ECT Appropriateness Scale (EAS).” The severity of depressive symptoms in the current episode appears, from the present study, to be the most important factor of those included in the EAS. This study is distinctive in evaluating ECT in less treatment‐resistant and less severely depressed patients who do not typically receive ECT or enter into ECT trials.…”

Section: Discussionmentioning

confidence: 99%

“…The US practice of using ECT primarily after other treatments have failed may be justified, if ECT is specifically beneficial only in treatment‐resistant cases. On the other hand, it is possible that ECT is similarly effective in highly symptomatic patients for whom treatment‐resistant has not been demonstrated, even though evidence of such efficacy is currently lacking (Dudleston, 2019; Kellner et al., 2015; Kellner, Popeo, Pasculli, Briggs, & Gamss, 2012).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of electroconvulsive therapy in patients with “less treatment‐resistant” depression by the Maudsley Staging Model

Rosenheck

et al. 2020

Brain and Behavior

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Introduction Electroconvulsive therapy (ECT) is an effective treatment for patients with mood disorders and is most often used for treatment‐resistant cases. This study aimed to examine the effectiveness of ECT in a real‐world treatment sample in a Chinese psychiatric hospital which included both treatment‐resistant and nontreatment‐resistant patients. Methods An observational study of symptom outcomes from admission to the time of discharge was conducted with 37 inpatients diagnosed with unipolar or bipolar depression treated with ECT. Symptom severity was assessed with the 17‐item Hamilton Rating Scales for Depression (HRSD‐17) and treatment‐resistance with the Maudsley Staging Model (MSM). Stratifying at the MSM median admission characteristics and symptom change was compared between patients who were treatment‐resistant ( n = 18) and who were not ( n = 19). The outcome difference between groups was compared using analyses of covariance adjusted for baseline characteristics including symptom severity, followed by linear regression to identify factors associated symptom improvement in the entire sample. Results The sample ( n = 37) showed moderate treatment‐resistance (MSM = 7.30 ± 1.13) at admission and both groups received 8.3 ± 2 ECT sessions. The treatment‐resistant group had a smaller proportion of bipolar patients and more severe symptoms, but showed no significant difference from the nontreatment‐resistant group in HDRS‐17 scores at the time of discharge (adjusted means = 6.23 ± 1.00 vs. 5.94 ± 0.97, Partial η 2 = 0.001, p = .845). Baseline symptom severity was the strongest correlate of reduction in HDRS‐17 scores ( β = 0.891, p < .001). Conclusions Symptom change with ECT in depression did not differ by level of treatment‐resistance but was greatest among those with more severe baseline symptoms. Correlates of ECT effectiveness should be further evaluated in stratified randomized trials.

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“…Another noteworthy model is the 3‐item ECT Appropriateness Scale (EAS) developed by Kellner et al. . Founding their selection of relevant variables, that is depression severity, heritability and episodic nature of depression, on the literature, their model was not validated in a patient sample.…”

Section: Discussionmentioning

confidence: 99%

The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression

Diermen

Hebbrecht

Schrijvers

et al. 2018

Acta Psychiatr Scand

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Objective: To investigate the potential role of the Maudsley Staging Method (MSM) in the prediction of electroconvulsive therapy (ECT) outcome in severely depressed adults. Method: Between August 2015 and August 2017, 73 consecutive patients with a major depressive episode (DSM-IV-TR) scheduled for ECT were recruited. Prior to their first ECT session, the MSM was completed to assess the level of therapy resistance. To determine the reduction in depression severity and response and remission rates, symptom severity was assessed at baseline and within one week after the last ECT session using the 17-item Hamilton Depression Rating Scale (HDRS17). Results: The percentage of symptom reduction following ECT was best predicted by the MSM episode duration and depression severity factors (R 2 completer sample 0.24). Episode duration alone was the best predictor of remission (area under the ROC curve for completers: 0.72). Adding age to the models increased their predictive capacity. Conclusion: An adapted version of the MSM gauging shorter episode duration, more severe depressive symptoms and older age is significantly associated with ECT effectiveness in adults with severe recurrent depression and is thus highly suitable for use in clinical practice, promoting the shared treatment decision-making process. Significant outcomes• The percentage of HDRS decrease can be predicted by an adapted version of the MSM, evaluating baseline depression severity and episode duration.• Remission was best predicted by depressive episode duration.• Adding age to the models improved their predictive capacities. • The adapted MSM has the potential to contribute to the treatment decision-making process in patients with depression. Limitations• Although the adapted MSM is a significant predictor, it can only explain part of ECT effectiveness.• The sample size of our study is limited. • Due to our observational design, there is substantial heterogeneity in patient and treatment characteristics.

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Appropriateness for electroconvulsive therapy (ECT) can be assessed on a three-item scale

Cited by 22 publications

References 22 publications

On the significance of elektroconvulsive therapy in the treatment of severe mental diseases

On the significance of elektroconvulsive therapy in the treatment of severe mental diseases

Effectiveness of electroconvulsive therapy in patients with “less treatment‐resistant” depression by the Maudsley Staging Model

The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression

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