A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?

Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT. Depressed adults according to MINI admi...

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Bibliographic Details
Published in:BMC psychiatry 2016-11, Vol.16 (1), p.396-396, Article 396
Main Authors: Alves, Lucas P C, Freire, Thiago F V, Fleck, Marcelo P A, Rocha, Neusa S
Format: Article
Language:English
Subjects:
Adult
Antidepressants
Antidepressive Agents - therapeutic use
Care and treatment
Clinical medicine
Clinical trials
Combined Modality Therapy
Depression, Mental
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - therapy
Dosage and administration
Drug dosages
Drug therapy
Electroconvulsive therapy
Electroconvulsive Therapy - methods
Electrodes
Female
Hospitalization
Humans
Inpatients
Length of Stay
Male
Mental depression
Middle Aged
Patients
Psychiatrists
Psychiatry
Psychosis
Response rates
Treatment Outcome
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Summary:Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT. Depressed adults according to MINI admitted in a psychiatric unit were divided in unilateral ECT treated and non-ECT treated. Main outcomes were: depression improvement in Hamilton Rating Scale for Depression (HDRS-17) scores; response (HDRS-17 improvement ≥50 %); remission (HDRS-17 score ≤7); length of hospitalization. Forty-three patients were included in unilateral ECT group and 104 in non-ECT group. No differences of psychotic symptoms, melancholic features or past maniac episode were found between groups. Unilateral ECT group had a mean HDRS-17 score higher than non-ECT group at admission (ECT: 25.05 ± 1.03; non-ECT: 21.61 ± 0.69; p = 0.001), but no significant difference was found at discharge (ECT: 7.70 ± 0.81; non-ECT: 7.40 ± 0.51; p = 0.75). Unilateral ECT group had a larger HDRS-17 score reduction during treatment (ECT: 18.24 ± 1.18; non-ECT:14.20 ± 0.76; p = 0.004). There were no significant differences in response and remission rates between groups. Unilateral ECT group had longer mean duration of hospitalization in days (ECT: 35.48 ± 2.48; non-ECT: 24.57 ± 1.50; p 
ISSN:1471-244X
1471-244X
DOI:10.1186/s12888-016-1095-z