Simon Lafrenière1,2, Fatemeh Gholi-Zadeh-Kharrat3,4, Caroline Sirois4,5,6, Victoria Massamba4, Louis Rochette4, Camille Brousseau-Paradis7, Simon Patry8,9, Christian Gagné10, Morgane Lemasson7, Geneviève Gariépy11,12, Chantal Mérette8,13, Elham Rahme14, Alain Lesage7,12. 1. Department of Psychiatry and Neurosciences, Université Laval, Quebec City, Qc, Canada. Simon.lafreniere.2@ulaval.ca. 2. Institut Universitaire en Santé Mentale de Québec, 2601, Chemin de La Canardière, Quebec, QC, G1J 2G3, Canada. Simon.lafreniere.2@ulaval.ca. 3. Department of Electrical Engineering and Computer Engineering, Université Laval, Quebec, Qc, Canada. 4. Institut National de Santé Publique du Québec, Quebec City, Qc, Canada. 5. Faculty of Pharmacy, Université Laval, Quebec, Qc, Canada. 6. Centre of Excellence on Aging of Quebec, VITAM Research Centre on Sustainable Health, Quebec City, Qc, Canada. 7. Department of Psychiatry and Addiction, Université de Montréal, Montreal, Qc, Canada. 8. Department of Psychiatry and Neurosciences, Université Laval, Quebec City, Qc, Canada. 9. Institut Universitaire en Santé Mentale de Québec, 2601, Chemin de La Canardière, Quebec, QC, G1J 2G3, Canada. 10. Computer Vision and Systems Laboratory, Université Laval, Quebec, Qc, Canada. 11. Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada. 12. Institut Universitaire en Santé Mentale de Montréal Research Centre, Montreal, Qc, Canada. 13. CERVO Research Centre, Quebec City, Canada. 14. Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, Qc, Canada.
Abstract
PURPOSE: Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize the longitudinal profile of psychopathology and services utilization of patients first treated with ECT. METHODS: We conducted a population-based comparative study using data from a national administrative database in Quebec. Patients who received a first ECT between 2002 and 2016 were compared to controls who were hospitalized in psychiatry but did not receive ECT. We performed descriptive analyses to compare psychiatric diagnoses, domains of psychopathology (internalizing, externalizing and thought/psychotic disorders), medical services and medication use in the 5 years prior to the ECT or hospitalization. RESULTS: 5 080 ECT patients were compared with 179 594 controls. Depressive, anxiety, bipolar and psychotic disorders were more frequent in the ECT group. 96.2% of ECT patients had been diagnosed with depression and 53.8% with a primary psychotic disorder. In the ECT group, 1.0% had been diagnosed exclusively with depression and 47.0% had disorders from that belong to all three domains of psychopathology. Having both internalizing and thought/psychotic disorders was associated with an increased likelihood of receiving ECT vs having internalizing disorders alone (unadjusted OR = 2.93; 95% CI = 2.63, 3.26). All indicators of mental health services utilization showed higher use among ECT patients. CONCLUSION: Our results provide robust evidence of complex longitudinal psychopathology and extensive services utilization among ECT patients.
PURPOSE: Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize the longitudinal profile of psychopathology and services utilization of patients first treated with ECT. METHODS: We conducted a population-based comparative study using data from a national administrative database in Quebec. Patients who received a first ECT between 2002 and 2016 were compared to controls who were hospitalized in psychiatry but did not receive ECT. We performed descriptive analyses to compare psychiatric diagnoses, domains of psychopathology (internalizing, externalizing and thought/psychotic disorders), medical services and medication use in the 5 years prior to the ECT or hospitalization. RESULTS: 5 080 ECT patients were compared with 179 594 controls. Depressive, anxiety, bipolar and psychotic disorders were more frequent in the ECT group. 96.2% of ECT patients had been diagnosed with depression and 53.8% with a primary psychotic disorder. In the ECT group, 1.0% had been diagnosed exclusively with depression and 47.0% had disorders from that belong to all three domains of psychopathology. Having both internalizing and thought/psychotic disorders was associated with an increased likelihood of receiving ECT vs having internalizing disorders alone (unadjusted OR = 2.93; 95% CI = 2.63, 3.26). All indicators of mental health services utilization showed higher use among ECT patients. CONCLUSION: Our results provide robust evidence of complex longitudinal psychopathology and extensive services utilization among ECT patients.
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Authors: A John Rush; Madhukar H Trivedi; Stephen R Wisniewski; Andrew A Nierenberg; Jonathan W Stewart; Diane Warden; George Niederehe; Michael E Thase; Philip W Lavori; Barry D Lebowitz; Patrick J McGrath; Jerrold F Rosenbaum; Harold A Sackeim; David J Kupfer; James Luther; Maurizio Fava Journal: Am J Psychiatry Date: 2006-11 Impact factor: 18.112