ORIGINAL ARTICLESA Meta-Analysis of Electroconvulsive Therapy Efficacy in DepressionKho, King Han MRCPsych*; van Vreeswijk, Michiel Floris MA†; Simpson, Steve MRCPysch§; Zwinderman, Aeilko H. PhD§ Author Information *GGZ Delfland, Locatie St Jorisweg, 2 Delft The Netherlands; †GGZ Delfland, Locatie Reinier de Graafweg, 3-11 Delft, The Netherlands; ‡Elderly Care, Yeatman Hospital Sherborne Dorset The United Kingdom; and §Academic Medical Center University of Amsterdam, Amsterdam The Netherlands Received May 13, 2002; accepted May 22, 2003 Address correspondence and reprint requests to King Han Kho, Waterloop 22 2614 XC Delft The Netherlands. E-mail: [email protected] The Journal of ECT: September 2003 - Volume 19 - Issue 3 - p 139-147 Buy Abstract Recently published controlled studies comparing electroconvulsive therapy (ECT) with other treatments for depression offer the opportunity to perform a meta-analysis of ECT in depression. Fifteen studies were identified which fulfilled the inclusion criteria. From these controlled trials, 20 effect sizes of ECT were calculated. The speed of action during the course and the efficacy after a full course of ECT were explored. The efficacy of sine wave and brief pulse machines were compared. The comparison between ECT and four other comparative treatments was made. Predictive variables were explored using homogeneity tests. ECT was shown to be superior after a full course. The funnel plot showed the absence of publication bias. There was no exaggeration of effect size in the lower quality trials. No evidence was found for a superior speed of action of ECT or for a difference in efficacy between sine wave and brief pulse stimulation. ECT was shown to be superior to medication and simulated ECT. Some evidence was found that psychosis predicted better response to ECT. © 2003 Lippincott Williams & Wilkins, Inc.