Differential response to right unilateral ECT in depressed patients: impact of comorbidity and severity of illness ISRCTN39974945Report as inadecuate




Differential response to right unilateral ECT in depressed patients: impact of comorbidity and severity of illness ISRCTN39974945 - Download this document for free, or read online. Document in PDF available to download.

BMC Psychiatry

, 2:2

First Online: 17 January 2002Received: 17 October 2001Accepted: 17 January 2002

Abstract

BackgroundRecent electroconvulsive therapy ECT efficacy studies of right unilateral RUL ECT may not apply to real life clinics with a wide range of patients with major depressive episodes.

MethodsThe study included two groups of patients. In addition to a homogeneous group of patients with major depression according to DSM-IV criteria with severity of the major depressive episode > 16 scores on 17-item Hamilton Rating Scale for Depression HDRS Group 1, n = 16, we included a heterogeneous group of patients with less severe major depressive episodes or with a variety of comorbid conditions Group 2, n = 24. We randomly assigned the patients to an RUL ECT treatment dosed at 5 or 2.5 times seizure threshold with an intent-to-treat design. The outcomes measured blindly were HDRS, number of treatments, and Mini-Mental State Examination MMSE. The patients were considered to have responded to treatment if the improvement in HDRS score was at least 60% and they had a total score of less than ten.

ResultsThe Group 2 patients responded poorer 8% vs. 63%, and had more often simultaneous worsening in their MMSE scores than Group 1 patients. The differences in the outcomes between the two different doses of RUL ECT treatment were not statistically significant.

ConclusionsECT effectiveness seems to be lower in real-life heterogeneous patient groups than in homogeneous patient samples used in experimental efficacy trials.

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Author: Pertti Heikman - Heikki Katila - Seppo Sarna - Kristian Wahlbeck - Kimmo Kuoppasalmi

Source: https://link.springer.com/







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