'Rapid speed of response to ECT in bipolar depression: A chart review

K W F Scheepstra; J B van Doorn; D S Scheepens; A de Haan; N Schukking; J B Zantvoord; A Lok

doi:10.1016/j.jpsychires.2022.01.008

'Rapid speed of response to ECT in bipolar depression: A chart review

J Psychiatr Res. 2022 Mar:147:34-38. doi: 10.1016/j.jpsychires.2022.01.008. Epub 2022 Jan 5.

Authors

K W F Scheepstra¹, J B van Doorn², D S Scheepens³, A de Haan³, N Schukking³, J B Zantvoord³, A Lok³

Affiliations

¹ Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands; Neuroimmunology Research Group, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105, BA, Amsterdam, the Netherlands. Electronic address: k.w.scheepstra@amsterdamumc.nl.
² Department of Psychological Methods, University of Amsterdam, Valckeniersstraat 59, 1018, XA, Amsterdam, the Netherlands.
³ Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.

PMID: 35007809
DOI: 10.1016/j.jpsychires.2022.01.008

Abstract

Objective: To validate a faster speed of response to electroconvulsive therapy (ECT) for bipolar depression (BPD) compared to major depressive disorder (MDD) METHOD: Retrospective chart review on an ECT cohort in an academic hospital setting. Speed of response was defined by the number of ECT treatments needed for response or remission.

Results: Sixty-four depressed patients were included, of whom 53 (MDD: 40, BPD: 13) could be analyzed. The bipolar group responded faster with a mean difference of 3.3 fewer ECT treatments to meet response criteria (MDD 10.4 vs. BPD 7.1, p = 0.054). When using mixed effects regression models for the response/remitter group (n = 35), a faster response for the bipolar group (AIC 252.83 vs 258.55, χ² = 11.72, p = 0.008) was shown. Other factors, such as psychotic features or comorbidity, did not influence the speed of response.

Conclusion: This chart review of an ECT cohort in an naturalistic academic hospital setting shows an evident and clinically relevant faster speed of response in bipolar depression.

Keywords: Bipolar disorder; Depression; Electroconvulsive therapy; Major depressive disorder.

MeSH terms

Bipolar Disorder* / therapy
Depressive Disorder, Major* / therapy
Electroconvulsive Therapy*
Humans
Retrospective Studies
Treatment Outcome