ECT-Related Anxiety During Maintenance ECT: New Study in Acta Psychiatrica Scandinavica

Out on PubMed, from researchers in Belgium and The Netherlands, is this study:

ECT-related anxiety during maintenance ECT: a prospective study.

Obbels J, Gijsbregts E, Verwijk E, Verspecht S, Lambrichts S, Vansteelandt K, Sienaert P.Acta Psychiatr Scand. 2022 Sep 8. doi: 10.1111/acps.13496. Online ahead of print.PMID: 36081255

The abstract is copied below:


Objective: Despite the established safety of electroconvulsive therapy (ECT), ECT-related anxiety (ERA) remains one of the most distressing complications of ECT. ERA is reported to diminish during an acute course of ECT, but it was never studied during maintenance ECT (M-ECT). Our aim was to study the trajectories of ERA during M-ECT and how they differ from trajectories during the acute course.

Methods: 39 patients with unipolar or bipolar depression, retained for M-ECT after an acute ECT course, were included. ERA was assessed the morning before each ECT session using the ECT-related Anxiety Questionnaire (ERAQ).

Results: ERA remained stable during M-ECT (RC=-0.05 (SE=0.06), t(8.35)=-0.86, p=0.42), while ERA declined significantly during the acute course (RC=-0.85 (SE=0.30), t(33.6)=-2.81, p=0.0082). During the acute course, patients with a psychotic depression were more anxious at baseline (t(32)=-2.42, p=0.02), and showed a significant decline in ERAQ scores (RC=-1.65 (SE=0.46), t(31.6)=-3.56, p=0.0012), whereas patients with a non-psychotic depression were less anxious at baseline and retained stable ERAQ scores during the acute course (RC=-0.06 (SE=0.41), t(32.1)=-0.14, p=0.89). Whereas a correlation (r=0.48) was noticed between the decline of depression severity and ERA during the acute course, this was not the case during M-ECT.

Conclusion: ERA runs a stable course during M-ECT, after having decreased during the acute course. During the acute course, ERA trajectories differed significantly between patients with a psychotic and non-psychotic depression. Decline of depression severity and ERA are significantly connected during the acute course of ECT. Both depression severity and ERA remain stable during M-ECT.

Keywords: ECT; anxiety; depression; maintenance treatment.

The article is here.

And from the text:





This is an excellent study on an important topic in patient tolerability of ECT. It is clearly written and the findings are also clear. Good to know that for many patients anxiety decreases during the acute course and remains lower during MECT. As the authors note, what to offer those patients with higher levels of anxiety needs further investigation.
Kudos to Dr. Obbels and colleagues for their diligent work in this previously neglected area of research.


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