GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, the Netherlands.
GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, the Netherlands.
J Affect Disord. 2020 Nov 1;276:984-990. doi: 10.1016/j.jad.2020.07.039. Epub 2020 Jul 18.
A substantial number of patients with late-life depression (LLD) that remitted after ECT experience relapse. Identifying risk factors for relapse may guide clinical management to devote attention to those at increased risk. Therefore the current study aims to evaluate which baseline clinical characteristics are related to relapse within six months after successful ECT in patients with severe LLD.
110 patients with LLD from the prospective naturalistic follow-up Mood Disorders in Elderly treated with Electro-Convulsive Therapy (MODECT) study were included. A total of 73 patients (66.4%) remitted after ECT, six patients had missing information on relapse, rendering to a total sample size of 67 patients. Relapse within six months after ECT was defined as a Montgomery Åsberg Depression Scale (MADRS)-score > 15, readmission or restart of ECT. Logistic regression analyses were conducted to examine the association between baseline clinical characteristics and relapse.
A total of 22 patients (32.8%) experienced a relapse. Patients with psychotic depression were less likely to relapse (odds ratio = 0.32, p = .047), corrected for prior admissions; 76.9% of patients with psychotic depression remained remitted.
Due to its naturalistic design, no firm conclusions can be drawn on the effect of post-ECT treatment.
Patients with psychotic depression had a lower risk to experience relapse after successful ECT. This result strengthens the hypothesis that psychotic depression might be a specific depression subtype with a favorable ECT outcome up to six months after ECT.
大量接受电休克治疗 (ECT) 后缓解的老年迟发性抑郁症 (LLD) 患者会复发。确定复发的风险因素可能有助于指导临床管理，将注意力集中在那些风险增加的患者身上。因此，本研究旨在评估哪些基线临床特征与严重 LLD 患者 ECT 后 6 个月内的复发有关。
来自前瞻性自然随访老年心境障碍接受电休克治疗（MODECT）研究的 110 例 LLD 患者被纳入研究。共有 73 例患者（66.4%）在 ECT 后缓解，6 例患者的复发信息缺失，总样本量为 67 例。ECT 后 6 个月内复发定义为蒙哥马利抑郁评定量表 (MADRS) 评分>15，再次住院或重新开始 ECT。进行逻辑回归分析以检查基线临床特征与复发之间的关联。
共有 22 例患者（32.8%）出现复发。伴有精神病性抑郁的患者复发的可能性较小（比值比=0.32，p=0.047），校正了既往住院次数；76.9%的精神病性抑郁患者仍保持缓解。
由于其自然设计，无法就 ECT 后治疗的效果得出确切结论。
在成功接受 ECT 后，伴有精神病性抑郁的患者复发的风险较低。这一结果支持了精神病性抑郁可能是一种特定的抑郁亚型的假说，在 ECT 后 6 个月内，ECT 治疗效果良好。
