One-Year Follow-Up After Successful ECT: A Naturalistic Study in Depressed Inpatients
J Clin Psychiatry 2004;65(1):87-91
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The aim of this study is to examine
both long-term efficacy of electroconvulsive therapy (ECT) and
the predictive value of adequate pre-ECT pharmacotherapy and the
presence of delusions in relation to post-ECT relapse in patients
who suffered from DSM-III-R major depression.
Method: Forty responders (a decrease in Hamilton
Rating Scale for Depression score >= 50%) to ECT were followed
for 1 year, the majority (N = 28) prospectively and the remainder
(N = 12) retrospectively. Relapse was defined as readmission, an
obvious decline in social functioning, or a change of
antidepressant medication caused by a clear worsening of
Results: Both 6- and 12-month post-ECT relapse
was significantly lower in patients with delusional depression
compared with nondelusional patients: 3/24 (12%) versus 8/15
(53%) and 5/24 (21%) versus 11/15 (73%), respectively. Relapse
rates for the whole sample were 11/39 (28%) at 6 months and 16/39
(41%) at 12 months. Regarding the impact of adequate pre-ECT
antidepressant trials on relapse, our data are inconclusive,
because only a few patients did not receive adequate
pharmacotherapy prior to ECT.
Conclusion: The remarkable finding of the
present study is the favorable 1-year outcome for patients with
delusional depression. The relapse rate for patients adequately
pretreated with antidepressants (45% over 1 year) is somewhat
more favorable than expected.