Demographic and Clinical Profile of Patients Receiving Electroconvulsive Therapy at a Tertiary Care Hospital in Oman: A Cluster Analysis

Abstract

Objectives We sought to identify subgroups of psychiatric patients in a sample of patients admitted at a tertiary care hospital in Oman who received electroconvulsive therapy (ECT) based on their demographic and clinical outcomes. Methods We retrospectively collected data from patients who received ECT at Al Massarah Hospital, Muscat, Oman, between January 2015 and December 2019. Sociodemographic characteristics, clinical profiles, and psychiatric comorbidities were examined. Results A total of 179 psychiatric patients received ECT; 96 (53.6%) were females. The average age at diagnosis was 42.5 years. Two-step cluster analysis showed 70 (39.1%) patients in cluster one and 109 (60.9%) patients in cluster two. Patients in cluster one included more (61.4%) females, were older (mean = 55.2 years), married (95.7%), and unemployed (88.6%). They reported they had comorbidities (55.7%) and less frequent ECT use (mean = 8.7) than patients in cluster two. Clusters differences were found on gender ( p = 0.001), age ( p < 0.001), marital status ( p < 0.001), and occupation ( p = 0.001). Significant differences were found for diagnosis ( p < 0.001), comorbid medical conditions ( p < 0.001), and use of ECT sessions ( p = 0.006). Conclusions Psychiatric patients receiving ECT are heterogeneous, with different demographic and clinical outcomes. Our study has shown that patients in cluster one are older females, unemployed, with more comorbidities, and depressive disorders, but received fewer ECT sessions. This study provides important information for clinicians to identify strategies to promote the use of ECT on its effectiveness and safety issues for each group.

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“…Possible explanations for this association, among other factors, include the severity of the disease and the urgent need for treatment in case of persistent suicidal ideation and catatonia. It is noteworthy that this aspect derived from our study contradicts most previous research, where married patients were more likely to undergo ECT [34][35][36][37]. A plausible explanation for this discrepancy could be the evolving social attitude towards mental illness and ECT treatment, which has seen increased acceptance in recent years.…”

“…Cluster one comprised older women with depressive disorders who received fewer ECT sessions. In contrast to cluster one, patients in cluster two were predominantly young men, most of whom had schizophrenia and required more sessions of ECT [35], results that are consistent with the findings of our study.…”

“…Patients who received benzodiazepines after ECT presented a significant decrease in this rate. These findings are corroborated by a study by Al Saadi et al that investigated a subset of psychiatric patients undergoing ECT to check if there were differences in demographic and clinical outcomes between subgroups [35]. Cluster one comprised older women with depressive disorders who received fewer ECT sessions.…”

Cluster analysis of hikikomori-like idiom of distress in Oman

“…Therefore, a two-step cluster analysis would be recommended as it could simultaneously analyze nominal and continuous data (Chan et al , 2022; Yalinay et al , 2022). According to the silhouette measure (low 0.2, acceptable 0.2–0.4, sufficiently good 0.5–1.0), clusters are more clearly distinguished (Chan et al , 2021; Al Saadi et al , 2022). When clusters had been identified within the samples, cluster comparison was performed.…”