OBJECTIVE: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe major depressive disorder. However, after acute-phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe major depressive disorder and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. METHODS: The authors performed 2 independent searches in PsychInfo (1806-2009) and MEDLINE (1948-2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, and shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of 6 articles (English language) that mentioned ECT and psychotherapy in the abstract and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. RESULTS: Although research over the past 7 decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. CONCLUSIONS: Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special adaptations in view of the cognitive effects of ECT.
OBJECTIVE: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe major depressive disorder. However, after acute-phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe major depressive disorder and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. METHODS: The authors performed 2 independent searches in PsychInfo (1806-2009) and MEDLINE (1948-2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, and shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of 6 articles (English language) that mentioned ECT and psychotherapy in the abstract and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. RESULTS: Although research over the past 7 decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. CONCLUSIONS: Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special adaptations in view of the cognitive effects of ECT.
Authors: A L Brody; S Saxena; P Stoessel; L A Gillies; L A Fairbanks; S Alborzian; M E Phelps; S C Huang; H M Wu; M L Ho; M K Ho; S C Au; K Maidment; L R Baxter Journal: Arch Gen Psychiatry Date: 2001-07
Authors: Nadia E Stellrecht; Kathryn H Gordon; Kimberly Van Orden; Tracy K Witte; LaRicka R Wingate; Kelly C Cukrowicz; Melanie Butler; Norman B Schmidt; Kathleen Kara Fitzpatrick; Thomas E Joiner Journal: J Clin Psychol Date: 2006-02
Authors: Ellen Frank; David J Kupfer; Daniel J Buysse; Holly A Swartz; Paul A Pilkonis; Patricia R Houck; Paola Rucci; Danielle M Novick; Victoria J Grochocinski; Deborah M Stapf Journal: Am J Psychiatry Date: 2007-05 Impact factor: 18.112
Authors: Harold A Sackeim; Joan Prudic; Mitchell S Nobler; Linda Fitzsimons; Sarah H Lisanby; Nancy Payne; Robert M Berman; Eva-Lotta Brakemeier; Tarique Perera; D P Devanand Journal: Brain Stimul Date: 2008-04 Impact factor: 8.955
Authors: Roumen V Milev; Peter Giacobbe; Sidney H Kennedy; Daniel M Blumberger; Zafiris J Daskalakis; Jonathan Downar; Mandana Modirrousta; Simon Patry; Fidel Vila-Rodriguez; Raymond W Lam; Glenda M MacQueen; Sagar V Parikh; Arun V Ravindran Journal: Can J Psychiatry Date: 2016-08-02 Impact factor: 4.356
Authors: Samuel T Wilkinson; Paul E Holtzheimer; Shan Gao; David S Kirwin; Rebecca B Price Journal: Biol Psychiatry Date: 2018-09-20 Impact factor: 13.382
Authors: Shawn M McClintock; Jimmy Choi; Zhi-De Deng; Lawrence G Appelbaum; Andrew D Krystal; Sarah H Lisanby Journal: J ECT Date: 2014-06 Impact factor: 3.635
Authors: Michael J Russell; Theodore Goodman; Ronald Pierson; Shane Shepherd; Qiang Wang; Bennett Groshong; David F Wiley Journal: J Biomed Res Date: 2013-10-25