Depression Severity in Electroconvulsive Therapy (ECT) Versus Pharmacotherapy Trials

Kellner, Charles H.; Kaicher, David C.; Banerjee, Hiya; Knapp, Rebecca G.; Shapiro, Rachael J.; Briggs, Mimi C.; Pasculli, Rosa M.; Popeo, Dennis M.; Ahle, Gabriella M.; Liebman, Lauren S.

doi:10.1097/yct.0000000000000135

Cited by 30 publications

(22 citation statements)

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“…Replication of our findings in a larger ECT sample would be valuable. With about one‐third being moderately depressed, the patients in our study were, on average, somewhat less severely depressed (HDRS17 of 24.8) than the rates reported in most ECT studies (HDRS17 of 27.6 ). Due to the observational design of our study, our sample inevitably comprised a combination of severely depressed patients with an acute ECT indication and depressed patients with often less severe but longer‐lasting depressive symptoms that had proved resistant to multiple antidepressant treatments.…”

Section: Discussioncontrasting

confidence: 53%

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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Section: Discussioncontrasting

confidence: 53%

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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“…Some studies in Poland and Slovakia revealed that ECT is primarily indicated for affective disorders like depression [3], while schizophrenia was the main indication for ECT in eastern Europe and Asia [4]. A recent study found that ECT is used more often than medications in severe cases of depression [5]. Several studies did not find any serious side effects of ECT such as epilepsy, brain damage, and pain [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Knowledge of and attitudes towards electroconvulsive therapy (ECT) among psychiatrists and family physicians in Saudi Arabia

et al. 2017

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ObjectivesTo assess the knowledge of and attitudes towards ECT among psychiatrists and family physicians in Saudi Arabia.MethodsThe study is quantitative observational cross-sectional with a convenient sample that included psychiatrists and family physicians (including residents) in Saudi Arabia.ResultsOf the 434 questionnaires emailed, a total of 126 returned completed questionnaires (29% response rate). The mean age of respondents was 35 years old. Psychiatrists accounted for 68.3%. The majority were Saudis (95.2%) and male (70.6%). Around half were consultants and about two-thirds (62.7%) had worked in a facility that used ECT. Psychiatrists showed better knowledge than family physicians in their answers, with a mean total knowledge scoring of 8.12 (±1.25) out of 10 and 6.15 (±1.25), respectively (P < 0.0001). Among psychiatrists, 87% thought that ECT required general anesthesia, while 35% of family physicians believed so (P < 0.0001). Other items of ECT knowledge are discussed. Psychiatrists displayed a better attitude towards ECT than family physicians in all answers, with a mean score of 9.54 (±1.16) and 7.85 (±2.39), respectively (P < 0.0001).ConclusionsPsychiatrists scored better than family physicians in both knowledge and attitude regarding ECT.

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“…Neuromodulatory interventions include ECT, magnetic seizure therapy, repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), vagal nerve stimulation (VNS), and deep brain stimulation (DBS). ECT is considered the first-line treatment for more severe forms of depression (Kellner et al, 2014). Recent MRI studies indicate that ECT may increase brain connectivity in depression, demonstrated by neuroplasticity of white matter microstructure suggesting increased fiber integrity of dorsal fronto-limbic pathways involved in mood regulation (Lyden et al, 2014).…”

Section: How the Neuroscience Of Depression Can Inform Interventionmentioning

confidence: 99%

The neuroscience of depression: Implications for assessment and intervention

Singh

Gotlib

2014

Behaviour Research and Therapy

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Major Depressive Disorder (MDD) is among the most prevalent of all psychiatric disorders and is the single most burdensome disease worldwide. In attempting to understand the profound deficits that characterize MDD across multiple domains of functioning, researchers have identified aberrations in brain structure and function in individuals diagnosed with this disorder. In this review we synthesize recent data from human neuroimaging studies in presenting an integrated neural network framework for understanding the impairments experienced by individuals with MDD. We discuss the implications of these findings for assessment of and intervention for MDD. We conclude by offering directions for future research that we believe will advance our understanding of neural factors that contribute to the etiology and course of depression, and to recovery from this debilitating disorder.

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Depression Severity in Electroconvulsive Therapy (ECT) Versus Pharmacotherapy Trials

Cited by 30 publications

References 0 publications

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

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

Knowledge of and attitudes towards electroconvulsive therapy (ECT) among psychiatrists and family physicians in Saudi Arabia

The neuroscience of depression: Implications for assessment and intervention

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