ECT Equally Effective in Women and Men: New Study From GEMRIC

 Out on PubMed, from international authors, is this study:

Sex-specifics of ECT outcome.

Blanken MAJT, Oudega ML, Hoogendoorn AW, Sonnenberg CS, Rhebergen D, Klumpers UMH, Van Diermen L, Birkenhager T, Schrijvers D, Redlich R, Dannlowski U, Heindel W, Coenjaerts M, Nordanskog P, Oltedal L, Kessler U, Frid LM, Takamiya A, Kishimoto T, Jørgensen MB, Jørgensen A, Bolwig T, Emsell L, Sienaert P, Bouckaert F, Abbott CC, Péran P, Arbus C, Yrondi A, Kiebs M, Philipsen A, van Waarde JA, Prinsen E, van Verseveld M, Van Wingen G, Funes CC, Kritzer M, Barbour T, Ten Doesschate F, van Eijndhoven P, Tendolkar I, Dols A.J Affect Disord. 2023 Jan 9:S0165-0327(22)01507-5. doi: 10.1016/j.jad.2022.12.144. Online ahead of print.PMID: 36632848

The abstract is copied below:

Objective: Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors.

Methods: Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms).

Results: Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women.

Conclusion: The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.

Keywords: ECT; Electroconvulsive therapy; Major depressive disorder; Phenotype; Predictor; Sex; Sex-specific.

The article is here.

And from the text:

Here is a fairly large study (n=500) from GEMRIC that demonstrates that ECT is equally effective in women and men. Well, we knew that, but it is important to document. The finding that shorter episode duration only affects outcome in women seems peculiar. Note that the average episode duration in this cohort was about 18 months! That suggests we need to educate practitioners better about timely prescription of ECT.

Kudos to our GEMRIC colleagues for continuing to mine their dataset.