Monitoring ECT-related anxiety: the ECT-related Anxiety questionnaire (ERAQ)

Vansteelandt

Verwijk

et al. 2020

Self Cite

Understanding electroconvulsive therapy-related anxiety: a prospective study. Aims of study: Although electroconvulsive therapy (ECT)-related anxiety is experienced by a significant proportion of patients, it remains understudied. Our aim was to study the course of ECT-related anxiety during ECT. Methods: Seventy-four patients with unipolar or bipolar depression, referred for ECT, were included. ECT-related anxiety was assessed the morning before each ECT session using the ECT-related Anxiety Questionnaire (ERAQ). Results: Female patients reported more anxiety than men (F (1,64.6) = 3.95, P = 0.05). Patients with a psychotic depression were more anxious before the start of ECT (F(64.8) = 4.57, P = 0.04), but experienced a significant decrease in ECT-related anxiety (t (63.9) = À3.63, P = 0.0006), whereas patients with a non-psychotic depression remained stable on anxiety during their ECT course (t (63,9) = 0.76, P = 0.45). In addition, we found a significant correlation between the decrease of ECT-related anxiety and the decrease of depression-severity (r = 0.35; P = 0.04). Conclusion: There are individual differences in ECT-related anxiety trajectories during ECT. Both female patients and patients with psychotic depression experienced more ECT-related anxiety before the start of ECT. The severity of ECT-related anxiety decreased significantly in patients with a psychotic depression, but remained stable in patients without a psychotic depression during ECT. In addition, patients who showed a stronger decrease in depression-severity also showed a stronger decrease in ECT-related anxiety. A better understanding of ECT-related anxiety trajectories can help in designing anxiety-reducing interventions.

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Assessmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Understanding electroconvulsive therapy‐related anxiety: a prospective study

Vansteelandt

Verwijk

et al. 2020

Self Cite

Neurocognitive functioning after electroconvulsive therapy in late‐life depression: A 4‐year prospective study

Vansteelandt

Bouckaert

et al. 2020

Objective Despite the proven efficacy and safety of ECT, there is still concern about the possible cognitive side effects of ECT in older patients. In this study, we aimed to characterize the long‐term cognitive effects of ECT in patients with late‐life depression (LLD) from before the start until 4 years after the index ECT course. Methods Fourty one patients aged 55 years and older with a unipolar depression, referred for ECT, were included. The neuropsychological test battery was assessed prior to ECT, 6 months, 1 year, 2 years, 3 years, and 4 years after the last ECT session. Results We did not find any statistically significant cognitive changes from before the start to 4 years after ending the ECT course. Although we could not detect cognitive changes at group level, we found clinically important differences on an individual level. Conclusion Cognitive performance in patients with LLD runs a stable course from before the start of ECT until 4 years after the index course. At an individual level, however, both cognitive decline and improvement can be witnessed. Older patients can tolerate ECT and most of them will not experience long‐term cognitive side effects.

ECT‐related anxiety during maintenance ECT: A prospective study

Gijsbregts

Verwijk

et al. 2022

Objective Despite the established safety of electroconvulsive therapy (ECT), ECT‐related anxiety (ERA) remains one of the most distressing complications of ECT. ERA is reported to diminish during an acute course of ECT, but it was never studied during maintenance ECT (M‐ECT). Our aim was to study the trajectories of ERA during M‐ECT and how they differ from trajectories during the acute course. Methods Thirty‐nine patients with unipolar or bipolar depression, retained for M‐ECT after an acute ECT course, were included. ERA was assessed the morning before each ECT session using the ECT‐related Anxiety Questionnaire (ERAQ). Results ERA remained stable during M‐ECT (RC = −0.05 (SE = 0.06), t(8.35) = −0.86, p = 0.42), while ERA declined significantly during the acute course (RC = −0.85 (SE = 0.30), t(33.6) = −2.81, p = 0.0082). During the acute course, patients with a psychotic depression were more anxious at baseline (t(32)= −2.42, p = 0.02), and showed a significant decline in ERAQ scores (RC = −1.65 (SE = 0.46), t(31.6) = −3.56, p = 0.0012), whereas patients with a non‐psychotic depression were less anxious at baseline and retained stable ERAQ scores during the acute course (RC = −0.06 (SE = 0.41), t(32.1) = −0.14, p = 0.89). Whereas a correlation (r = 0.48) was noticed between the decline of depression severity and ERA during the acute course, this was not the case during M‐ECT. Conclusion ERA runs a stable course during M‐ECT, after having decreased during the acute course. During the acute course, ERA trajectories differed significantly between patients with a psychotic and non‐psychotic depression. Decline of depression severity and ERA are significantly connected during the acute course of ECT. Both depression severity and ERA remain stable during M‐ECT.