Suicidal Ideation and ECT: New Data

Out on PubMed, in Acta, from the Harvard group and MUSC, is this study:

Changes in self-reported suicidal ideation during treatment with electroconvulsive therapy: A retrospective cohort study.

Luccarelli J, Humphrey D, McCoy TH Jr, Henry ME, Mueller M, Seiner SJ.Acta Psychiatr Scand. 2023 Aug 29. doi: 10.1111/acps.13603. Online ahead of print.PMID: 37643775

The abstract is copied below:

Objective: Suicidal ideation (SI) is common in patients with depressive symptoms, who are the most common recipients of electroconvulsive therapy (ECT). We sought to quantify changes in self-reported SI occurring during treatment with ECT, and to identify factors associated with persistence of SI in patients beginning treatment with SI.

Method: Retrospective, single-center cohort study of patients receiving ECT and who self-reported symptoms using Quick Inventory of Depressive Symptomatology (QIDS) prior to ECT and after treatment #5 or #10. Changes in QIDS-reported SI over the course of ECT were calculated, and logistic regression models were performed to assess factors associated with reporting SI at the end of treatment.

Results: 2554 provided baseline and follow-up SI scores, of whom, 1931 (75.6%) endorsed SI at baseline. There was a reduction in SI with ECT treatment (McNemar's test; df = 1, Χ2 = 803.7; p < 0.001), and in adjusted models 64.0% of individuals with baseline SI reported resolution of SI with ECT treatment, while 3.3% without baseline SI reported SI at the end of treatment. Higher baseline SI severity and outpatient treatment were associated with a higher odds of persistent SI among individuals beginning treatment with SI.

Conclusion: Electroconvulsive therapy treatment was associated with reductions in self-reported SI. These results support the use of ECT in the treatment of patients with SI, but further research is needed to determine the effects of ECT on suicidal behavior.

Keywords: cohort studies; electroconvulsive therapy; real world evidence; suicidal ideation; suicide.

The paper is here.
And from the text:


Here is yet another excellent study from the Harvard group and colleagues from the Medical University of South Carolina. Despite the limitations of retrospective and self-rated data, this is a very large sample with encouraging results.

Kudos to these authors for this helpful contribution to the evidence base for ECT as a beneficial treatment for patients with suicidal ideation as part of their depressive illness.

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