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Differential response to right unilateral ECT in depressed patients: impact of comorbidity and severity of illness [ISRCTN39974945].

https://arctichealth.org/en/permalink/ahliterature191499
Source
BMC Psychiatry. 2002;2:2
Publication Type
Article
Date
2002
Author
Pertti Heikman
Heikki Katila
Seppo Sarna
Kristian Wahlbeck
Kimmo Kuoppasalmi
Author Affiliation
Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland. pertti.heikman@hus.fi
Source
BMC Psychiatry. 2002;2:2
Date
2002
Language
English
Publication Type
Article
Keywords
Comorbidity
Depressive Disorder - diagnosis - epidemiology - therapy
Electroconvulsive Therapy - methods
Female
Finland - epidemiology
Functional Laterality - physiology
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Psychiatric Status Rating Scales
Severity of Illness Index
Treatment Outcome
Abstract
Recent electroconvulsive therapy (ECT) efficacy studies of right unilateral (RUL) ECT may not apply to real life clinics with a wide range of patients with major depressive episodes.
The study included two groups of patients. In addition to a homogeneous group of patients with major depression according to DSM-IV criteria with severity of the major depressive episode > 16 scores on 17-item Hamilton Rating Scale for Depression (HDRS) (Group 1, n = 16), we included a heterogeneous group of patients with less severe major depressive episodes or with a variety of comorbid conditions (Group 2, n = 24). We randomly assigned the patients to an RUL ECT treatment dosed at 5 or 2.5 times seizure threshold with an intent-to-treat design. The outcomes measured blindly were HDRS, number of treatments, and Mini-Mental State Examination (MMSE). The patients were considered to have responded to treatment if the improvement in HDRS score was at least 60% and they had a total score of less than ten.
The Group 2 patients responded poorer (8% vs. 63%), and had more often simultaneous worsening in their MMSE scores than Group 1 patients. The differences in the outcomes between the two different doses of RUL ECT treatment were not statistically significant.
ECT effectiveness seems to be lower in real-life heterogeneous patient groups than in homogeneous patient samples used in experimental efficacy trials.
Notes
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PubMed ID
11846888 View in PubMed
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[New insights into electroconvulsive therapy].

https://arctichealth.org/en/permalink/ahliterature179337
Source
Duodecim. 2004;120(10):1219-25
Publication Type
Article
Date
2004
Author
Pertti Heikman
Author Affiliation
Helsingin yliopisto Kliininen laitos, HYKS:n psykiatrian klinikka, Lapinlahden sairaala PL 320, 00029 HUS. pertti.heikman@hel.fi
Source
Duodecim. 2004;120(10):1219-25
Date
2004
Language
Finnish
Publication Type
Article
Keywords
Depressive Disorder - diagnosis - therapy
Electroconvulsive Therapy - adverse effects - methods
Female
Finland
Humans
Male
Prognosis
Risk assessment
Seizures - epidemiology - etiology
Severity of Illness Index
Treatment Outcome
PubMed ID
15232980 View in PubMed
Less detail