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Efficacy of Continuation/Maintenance Electroconvulsive Therapy in the Treatment of Patients With Mood Disorders

A Retrospective Analysis

Hausmann, Armand, MD*; Post, Thomas, MD*; Post, Fabienne, MD*; Dehning, Julia, MD*; Kemmler, Georg, MD*; Grunze, Heinz, MD†‡

doi: 10.1097/YCT.0000000000000547
Original Studies

Objective The aim of the study was to contribute evidence for the efficacy of continuation and maintenance electroconvulsive therapy (c/mECT) going beyond the existing literature by examining longer-term outcomes from a single center.

Methods We conducted a retrospective observational cohort study for a 14-year period, in which a group of 27 individuals with mood disorders, as defined by International Classification of Diseases-10, were examined and received acute ECT, followed by c/mECT. Mirror-image comparison of individual data sets, 5 years before and after c/mECT, was conducted for the number and mean duration of hospitalizations, as well as inpatient days per year. Statistical analysis was performed using general equation estimation modeling.

Results In 27 patients (63% female, mean ± SD age = 54.3 ± 11.7 years) experiencing either from bipolar (41%) or unipolar (59%) mood disorder, with most patients presenting with a depressive episode at hospital admission (93%), c/mECT was initiated after a successful course of acute ECT in addition to treatment as usual. In a 5-year period before and after starting c/mECT, we observed a significant decline in the mean number of hospitalizations per year (0.64 vs 0.32, P = 0.031), the average number of inpatient days per year (23.7 vs 6.1 days, P < 0.001), and the mean duration of hospital stays (41.6 vs 22.1 days, P = 0.031).

Conclusions The findings provide further support for the efficacy of c/mECT as an augmentation therapy to psychopharmacological treatment in patients experiencing mood disorders, who have responded to acute ECT. Further studies, however, using a controlled study design and larger sample sizes are needed.

From the *Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria;

Zentrum für Psychiatrie Weinsberg, Klinikum am Weissenhof, Weinsberg; and

Paracelsus Medical University, Nuremberg, Germany.

Received for publication June 23, 2018; accepted August 17, 2018.

Reprints: Armand Hausmann, MD, Medical University of Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics Division of Psychiatry I Anichstrasse 35 6020 Innsbruck, Austria (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

Presented at the cojoint World Congress of Psychiatry/Jahrestagung der Deutschen Gesellschaft für Psychiatrie und Psychotherapie Meeting, Berlin, Germany, October 10, 2017.

Online date: October 22, 2018

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