J Korean Soc Biol Ther Psychiatry.  2022 Oct;28(3):98-108.

Clinical Factors Related to Change of Depression Severity in Major Depressive Disorder Through Index Electroconvulsive Therapy

Affiliations
  • 1Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea

Abstract


Objectives
:The aim of this study was to investigate the factors associated with changes in depression severity in index electroconvulsive therapy (ECT) for major depressive disorder.
Methods
:A retrospective analysis was performed on 80 patients with major depressive disorder who received index ECT. The severity of depression was assessed using the Hamilton depression rating scale-17 (HDRS-17). Multiple linear regression analysis and logistic regression analysis were performed to identify the factors associated with the change of depression severity and the predictors of the 50% or greater reduction rate of HDRS-17.
Results
:55 (68.8%) patients were HDRS-17 score change ≥50% group, and 25 (31.2%) patients were HDRS-17 score change <50% group. HDRS-17 score change ≥50% group had a shorter episode duration before ECT (11.91±8.63 vs 17.68±11.15 weeks, p=0.027) and more ECT sessions (8.60±2.91 vs 6.80±3.34 sessions, p=0.017). The higher baseline score of anxiety (B=0.937, β=0.374, p<0.001), depression (B=0.846, β=0,324, p=0.001), and somatic symptom (B=0.995, β=0.210, p=0.031) dimensions was associated with the change of HDRS-17 score from baseline. The longer episode duration until the start of ECT was associated with lower likelihood of HDRS-17 score change ≥50% (Wald χ2 =7.74, OR=1.08, 95% CI: 1.02-1.14, p=0.005). The greater number of ECT sessions predicted the HDRS-17 score change ≥50% (Wald χ2 =7.85, OR=0.75, 95% CI=0.62-0.92, p=0.005) Conclusions:In higher baseline anxiety, depression, and somatic symptoms severity, implementing sufficient sessions of ECT in pharmacological treatment phase of relatively shorter duration of major depressive episode may help reduce HDRS-17 score.

Keyword

Electroconvulsive therapy; Major depressive disorder; Depression; Anxiety; Regression analysis
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