The effects of treatment, clinical and demographic factors on recovery of orientation after ECT: A care network study.

Autor: Barreiros AR; Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Australia; Brain Dynamics Centre, The Westmead Institute for Medical Research, Australia; Faculty of Medicine and Health, University of Sydney, Australia., Massaneda-Tuneu C; Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Australia., Waite S; The Queen Elizabeth Hospital, Australia., Sarma S; Gold Coast Health, Australia; Faculty of Health Sciences and Medicine, Bond University, Australia., Branjerdporn G; Gold Coast Health, Australia; Faculty of Health Sciences and Medicine, Bond University, Australia; University of Queensland-Mater Research Institute, Australia., Zeng C; Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Australia., Dong V; Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Australia., Loo C; Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Australia., Martin DM; Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Australia.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2025 Jan 01; Vol. 368, pp. 337-342. Date of Electronic Publication: 2024 Sep 16.
DOI: 10.1016/j.jad.2024.09.097
Abstrakt: Background: Time to reorientation after electroconvulsive therapy (ECT) has been shown to predict retrograde amnesia and is a useful measure for monitoring patients over the acute treatment course. This study investigated the effects of treatment, clinical and demographic factors on the recovery of orientation after ECT.
Methods: Data from 555 ECT patients across two different clinical CARE Network sites were analysed. The main outcome variable was recovery of orientation on the 10-Item Orientation Questionnaire assessed after every ECT treatment. A linear mixed-effects repeated measures model was used to predict the recovery of orientation across the ECT course based on multiple factors, including age, gender, electrode montage, ECT number and frequency, diagnosis, and baseline cognitive impairment.
Results: Type of ECT demonstrated a significant effect (F(2, 2341) = 48.414, p = 0.000): individuals who received right unilateral (RUL) ultrabrief ECT or bifrontal ECT had higher orientation scores compared to those who received RUL brief pulse ECT. Older age groups and female patients had lower orientation scores. Baseline global cognitive functioning significantly influenced orientation scores (F(3, 2339) = 43.597, p = 0.000), with individuals with no or mild cognitive impairment exhibiting higher scores.
Limitations: The study involved a retrospective analysis of de-identified data, which may have introduced inherent biases with missing data.
Conclusions: This large-scale retrospective, real-world study showed that recovery of orientation after ECT was most affected by ECT type, though age, gender, and baseline level cognitive impairment also affected outcomes. These findings can inform the interpretation of post ECT orientation scores, facilitating its monitoring and optimisation of patient outcomes.
Competing Interests: Declaration of competing interest None of the authors of this manuscript have conflicts of interest to disclose.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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