Predictors for the Efficacy of Electroconvulsive Therapy: Chart Review of a Naturalistic Study
J Clin Psychiatry 2005;66(7):894-899
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Several variables have been
suggested that can predict the efficacy of electroconvulsive
therapy (ECT) in patients suffering from depression. The results
of studies into these predictors for ECT efficacy are not
Method: In a retrospective chart review
of patients suffering from major depressive disorder and bipolar
disorder according to DSM-IV criteria who have been given ECT in
a psychiatric hospital in the Netherlands, predictors for ECT
efficacy were explored. Information was gathered for predictors
including sex, age, diagnosis, presence of psychosis, duration of
index episode, medication treatment failure prior to ECT,
medication during ECT course, and ECT variables. ECT was given
twice weekly from November 1997 to June 2002. The 17-item
Hamilton Rating Scale for Depression (HAM-D) was applied at
baseline and weekly during the course.
Results: Seventy-three patients suffering
from unipolar or bipolar depression were given ECT in the study
period, with 56 patients (77%) meeting antidepressant treatment
history form criteria for medication treatment failure. With
remission defined as a reduction of depressive symptoms of at
least 60% from baseline and a HAM-D end score of less than 8, 48
patients (65.8%) remitted. Forward stepwise logistic regression
analysis selected only duration of index episode as a significant
predictor for ECT efficacy. Medication treatment failure was not
found to be a significant predictor. The concurrent use of
psychotropic medication during ECT did not influence the
Conclusion: Duration of index episode was
the only variable found to significantly predict the efficacy of