Factors associated with early and late response to electroconvulsive therapy.

Autor: Hart KL; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA., McCoy TH Jr; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA., Henry ME; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA., Seiner SJ; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA., Luccarelli J; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Acta psychiatrica Scandinavica [Acta Psychiatr Scand] 2023 Apr; Vol. 147 (4), pp. 322-332. Date of Electronic Publication: 2023 Feb 20.
DOI: 10.1111/acps.13537
Abstrakt: Objective: Electroconvulsive therapy (ECT) is an effective treatment for severe depressive symptoms, yet more research is needed to examine predictors of treatment response, and factors associated with response in patients not initially improving with treatment. This study reports factors associated with time to response (early vs. late) to ECT in a real-world setting.
Methods: This was a retrospective, single-center cohort study of patients endorsing moderate to severe depressive symptoms using the Quick Inventory of Depressive Symptomatology (QIDS; QIDS>10). Response was defined as 50% or greater decrease in QIDS score from baseline. We used logistic regression to predict response at treatment #5 (early response) as well as after treatment #5 (late response) and followed patients through ECT discontinuation or through treatment #20.
Results: Of the 1699 patients included in this study, 555 patients (32.7%) responded to ECT treatment at treatment #5 and 397 (23.4%) responded after treatment #5. Among patients who did not respond by treatment #5, those who switched to brief pulse width ECT from ultrabrief pulse ECT had increased odds of response after treatment #5 compared with patients only receiving ultrabrief pulse (aOR = 1.55, 95% CI: 1.16-2.07). Additionally, patients with less improvement in QIDS from baseline to treatment #5 had decreased odds of response after treatment #5 (aOR = 0.97, 95% CI = 0.97-0.98).
Conclusion: Among depressed patients treated with ECT, response occurred in 56.0% of patients by treatment #20. Patient receiving ultrabrief pulse ECT at baseline and who did not respond by treatment #5 had greater odds of subsequent response if switched to brief pulse ECT than if continued with ultrabrief pulse.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje