Spontaneous length of depression and response to ECT

Kukopulos, A.; Reginaldi, Daniela; Tondo, Luigi; Bernabei, Annalisa; Caliari, B.

doi:10.1017/s0033291700006279

Cited by 28 publications

(9 citation statements)

References 9 publications

(12 reference statements)

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“…In agreement with earlier studies 49,[54][55][56][57] (Table 5), we found that chronicity of depression (i.e., depression with a duration longer than 2 years) independently predicted a lower remission rate.…”

Section: Chronicity Of Depression and Response To Ectsupporting

confidence: 93%

Predictors of Remission After Electroconvulsive Therapy in Unipolar Major Depression

Dombrovski¹,

Mulsant²,

Haskett³

et al. 2005

J. Clin. Psychiatry

119

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Context: Electroconvulsive therapy (ECT) is the most effective biological treatment for major depression. However, there is little agreement about clinically useful predictors of acute ECT outcomes. Objective: To assess whether age, sex, burden of comorbid physical illness, age at onset, history of recurrence, episode duration, chronic depression or comorbid dysthymia, melancholic features, episode severity, and medication resistance are predictors of remission after an acute course of ECT. Design: We performed an analysis using data gathered prospectively in 328 patients with unipolar major depression (according to Research Diagnostic Criteria) treated with ECT. The study was conducted from 1993 through 1999. Patients had a pretreatment score of 21 or higher on the 24-item Hamilton Rating Scale for Depression (HAM-D). Treatment history was assessed using the Antidepressant Treatment History Form. Remission was defined as a 24-item HAM-D score of 10 or less and a 60% or more relative reduction of the HAM-D score. Results: On univariate logistic regression, statistically significant predictors of nonremission were chronic depression/dysthymia, medication resistance, longer episode duration, and younger age. On backward elimination logistic regression, only medication resistance (OR = 1.67, 95% CI = 1.05 to 2.67) and chronic depression/ dysthymia (OR = 1.84, 95% CI = 1.06 to 3.21) were statistically significant predictors of nonremission. Conclusions: In patients with major depression, lower rates of remission after acute ECT are associated with medication resistance and chronicity, but not with age or burden of physical illness.

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Section: Chronicity Of Depression and Response To Ectsupporting

confidence: 93%

Predictors of Remission After Electroconvulsive Therapy in Unipolar Major Depression

Dombrovski¹,

Mulsant²,

Haskett³

et al. 2005

J. Clin. Psychiatry

119

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“…j) ECT should on average be more effective late in the course of a depression, since type 1 can convert to type 2 but only the latter is likely to respond to this treatment. This is an old observation confirmed by Kukopulos et al (1977). k) Delusional depression (intermediate between type 2 depression and schizophrenia) should respond to ECT or to neuroleptics (confirmed by Kantor & Glassman (1977) and Nelson & Bowers (1978)).…”

Section: Predictionsmentioning

confidence: 76%

A model of the functional psychoses

Nunn

1980

Acta Psychiatr Scand

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“…2,44 Studies examining speed of response have generally found that patients with bipolar depression showed a more rapid response and required fewer ECT treatments than patients with MDD 1,3,45,46 In the present study, the association of remission with shorter length of the depressive episode is consistent with previous reports that a longer duration of depression predicted a lower response rate to ECT. [47][48][49][50] From our study, it is not possible to infer whether some patients are intrinsically resistant to treatment and have prolonged episodes for that reason or whether ineffective treatments, in prolonging the episode, contribute to an active process that makes patients difficult to treat. 51 Number of lifetime days spent in depression has been associated with the degree of hippocampal atrophy, implicating an active degenerative process.…”

Section: Discussionmentioning

confidence: 99%