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Clinical factors related to acute electroconvulsive therapy outcome for patients with major depressive disorder

Chen, Cheng-Chung; Lin, Ching-Hua; Yang, Wei-Cheng; Chen, Ming-Chao

International Clinical Psychopharmacology: May 2017 - Volume 32 - Issue 3 - p 127–134
doi: 10.1097/YIC.0000000000000167
ORIGINAL ARTICLES
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The aim of this study was to explore the significant predictors associated with electroconvulsive therapy (ECT) outcome for patients with major depressive disorder. Major depressive disorder inpatients (N=130) requiring ECT were recruited from a major psychiatric center in South Taiwan. ECT was generally performed for a maximum of 12 sessions. Symptom severity was assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17) and Clinical Global Impression of Severity (CGI-S) before ECT, after every three ECT sessions, and after the last ECT. The generalized estimating equations method was used to analyze the influence of potential variables over time on the HAMD-17 and CGI-S, respectively. Fourteen patients not completing the first three sessions of ECT were excluded. The remaining 116 patients were included in the analysis. Patients with treatment-resistant depression, longer duration of the current depressive episode, and higher levels of pain were more likely to have less symptom reduction after acute treatment with ECT, irrespective of how the depressive symptoms were rated using HAMD-17 or CGI-S. To improve efficacy, earlier application of ECT and pain control should be considered during an acute course of ECT. Other clinical predictors related to ECT outcome require further investigation in future studies.

aDepartment of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital

bDepartment of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence to Ching-Hua Lin, MD, PhD, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan Tel: +886 7 751 3171 x2373; fax: +886 716 1843; e-mail: chua.lin@msa.hinet.net

Received August 1, 2016

Accepted January 17, 2017

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