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.
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.
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).
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: email@example.com).
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