Thomas Post1, Georg Kemmler2, Tristan Krassnig2, Anita Brugger2, Armand Hausmann2. 1. Department Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich. thomas.post@uki.at. 2. Department Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Abstract
BACKGROUND: Continuation and maintenance electroconvulsive therapy (c/m ECT) is a long-term treatment option in severely and chronically ill patients with mood disorders, who are unresponsive or intolerant to medication. Due to the current lack of empirical studies, c/m ECT is still a clinical tool with little evidence. METHODS: We conducted a retrospective analysis of patients' charts who received c/m ECT over a 10-year period. Outcome was measured by comparing the number of pre-c/m ECT and post-c/m ECT hospitalizations, as well as inpatient days per year and mean duration of hospital stays. RESULTS: In 19 patients (63% female; mean age 53.5 ± 12.0 years) with either bipolar (42%) or unipolar (58%) mood disorder, with the majority of patients suffering from a depressive episode at hospital admission (95%), c/m ECT was initiated after a successful series of ECT. In a 5-year interval before and after starting c/m ECT the number of hospitalizations per year (0.87 vs. 0.28, p < 0.001), inpatient days per year (30.8 vs. 4.5 days, p < 0.001), as well as the mean duration of hospital days (30.5 vs. 16.7 days, p = 0.02) decreased significantly. CONCLUSION: Our data support previous results showing that c/m ECT is an efficacious option in treating and favourably altering the course of therapy-resistant affective disorders. Further research using a controlled study design and larger sample sizes are needed to convincingly define indication and performance of c/m ECT.
BACKGROUND: Continuation and maintenance electroconvulsive therapy (c/m ECT) is a long-term treatment option in severely and chronically ill patients with mood disorders, who are unresponsive or intolerant to medication. Due to the current lack of empirical studies, c/m ECT is still a clinical tool with little evidence. METHODS: We conducted a retrospective analysis of patients' charts who received c/m ECT over a 10-year period. Outcome was measured by comparing the number of pre-c/m ECT and post-c/m ECT hospitalizations, as well as inpatient days per year and mean duration of hospital stays. RESULTS: In 19 patients (63% female; mean age 53.5 ± 12.0 years) with either bipolar (42%) or unipolar (58%) mood disorder, with the majority of patients suffering from a depressive episode at hospital admission (95%), c/m ECT was initiated after a successful series of ECT. In a 5-year interval before and after starting c/m ECT the number of hospitalizations per year (0.87 vs. 0.28, p < 0.001), inpatient days per year (30.8 vs. 4.5 days, p < 0.001), as well as the mean duration of hospital days (30.5 vs. 16.7 days, p = 0.02) decreased significantly. CONCLUSION: Our data support previous results showing that c/m ECT is an efficacious option in treating and favourably altering the course of therapy-resistant affective disorders. Further research using a controlled study design and larger sample sizes are needed to convincingly define indication and performance of c/m ECT.
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