Bipolar Depression Requires Fewer ECT: New Study From the Netherlands

Out on PubMed, from researchers in the Netherlands, is this paper:

Rapid speed of response to ECT treatment in bipolar depression: A chart review.

Scheepstra KWF, van Doorn JB, Scheepens DS, de Haan A, Schukking N, Zantvoord JB, Lok A.J Psychiatr Res. 2022 Jan 5;147:34-38. doi: 10.1016/j.jpsychires.2022.01.008. Online ahead of print.PMID: 35007809

The abstract is copied below:

Objective: To validate a faster speed of response to electroconvulsive therapy (ECT) for bipolar depression (BPD) compared to major depressive disorder (MDD) METHOD: Retrospective chart review on an ECT cohort in an academic hospital setting. Speed of response was defined by the number of ECT treatments needed for response or remission.

Results: Sixty-four depressed patients were included, of whom 53 (MDD: 40, BPD: 13) could be analyzed. The bipolar group responded faster with a mean difference of 3.3 fewer ECT treatments to meet response criteria (MDD 10.4 vs. BPD 7.1, p = 0.054). When using mixed effects regression models for the response/remitter group (n = 35), a faster response for the bipolar group (AIC 252.83 vs 258.55, χ2 = 11.72, p = 0.008) was shown. Other factors, such as psychotic features or comorbidity, did not influence the speed of response.

Conclusion: This chart review of an ECT cohort in an naturalistic academic hospital setting shows an evident and clinically relevant faster speed of response in bipolar depression.

Keywords: Bipolar disorder; Depression; Electroconvulsive therapy; Major depressive disorder.

The article is here.

And from the text:




This is a small (only 13 bipolar patients), retrospective chart review replicating the well-known finding of faster ECT response in bipolar patients. These data also replicate the finding of higher response rates in patients with psychotic depression. Figure 2 (above) is stellar.
 Any evidence to combat the long-held misbelief that there is little proof of ECT's efficacy in bipolar depression is welcome, so kudos to these authors for putting this into the ECT literature. A full read is~ 15 minutes.

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