Improvement of cycloid psychosis following electroconvulsive therapy

Abstract

Background: The treatment of choice for cycloid psychosis has traditionally been electroconvulsive therapy (ECT), but there is a lack of studies on its effectiveness. Aims: The primary aim of this register study was to determine the rates of remission and response after ECT for cycloid psychosis. The secondary aim was to examine possible predictors of outcome. Methods: Data were obtained from the National Quality Register for ECT in Sweden. The study population was patients (n ¼ 42) who received ECT for acute polymorphic psychotic disorder without symptoms of schizophrenia or for cycloid psychosis between 2011-2015 in 13 hospitals. Remission and response rates were calculated using Clinical Global Impression-Severity (CGI-S) and -Improvement scores, respectively. Variables with possible predictive value were tested using Chi-square and Fisher's exact test. Results: The response rate was 90.5%. The remission rate was 45.2%. Of 42 patients, 40 improved their CGI-S score after ECT (p < 0.001). The mean number of ECT treatments was 2.5 for non-responders and 7.0 for responders (p ¼ 0.010). The mean number of ECT treatments did not differ significantly between remitters and non-remitters (7.2 vs 6.1, p ¼ 0.31). None of the other investigated potential predictors was statistically significantly associated with outcome. Conclusions: ECT is an effective treatment for cycloid psychosis. Future studies need to compare the outcome of ECT to that of other treatment strategies. Clinical implications: The high response rate with ECT indicates that cycloid psychosis is a clinically useful diagnosis.

Electroconvulsive Therapy Before or After Initiation of Clozapine in Schizophrenia- A Retrospective Comparison for Seizure Parameters, Treatment Response and Duration of Hospitalization

“…In our study, there was no significant difference between C-ECT and ECT-B groups and the response rates were high in both groups. For psychotic disorders, women have higher ECT response and remission rates as reported previously in the literature (23). A previous naturalistic study from a different center in our country also reported high response rates, which the researchers interpreted to be due to careful selection of possible good responders for ECT by clinicians as they conclude (24).…”

Delaying initiation of electroconvulsive treatment after administration of the anaesthetic agent and muscle relaxant reduces the necessity of re-stimulation

“…In the current study patients were mainly diagnosed with affective disorders, and possible effects on psychosis is harder to elucidate. Previous studies have shown an effect of adding ECT to antipsychotic treatment in primary psychosis (25,26), and the effects shown in the current study could most likely also apply to this population.…”

Emerging cycloid psychosis episodes during COVID-19 pandemic: a case series

“…Lithium could have a certain response rate in the prevention of recurrences [29,30]. Electroconvulsive therapy is also an effective treatment for the acute phase with a high response rate [31], particularly when there is a predominance of motor features [32]. However, 20% of relapses were observed during the first year of follow-up in patients treated with electroconvulsive therapy in the acute phase [33].…”