Benefits of Early ECT: New Data From Singapore

Out on PubMed, from authors in Singapore, is this study:

Effect of early electroconvulsive therapy on length of stay in patients with bipolar, depressive and psychotic disorders.

Goh SE, Tan XW, Tor PC.Schizophr Res. 2023 Sep 16;261:139-144. doi: 10.1016/j.schres.2023.09.022. Online ahead of print.PMID: 37722210

The abstract is copied below:

Objective: There is limited literature examining the effect of early electroconvulsive therapy(ECT) on the length of stay(LOS), especially for psychotic disorders. This study aimed to evaluate the association between early ECT and LOS in three main groups of patients with bipolar, depressive and primary psychotic disorders.

Method: A retrospective descriptive analysis of 464 patients who received inpatient ECT from May 2017 to March 2021 in a large tertiary psychiatric institution was conducted. Early ECT was defined as ECT done before the mean number of days from admission to initiation of ECT by diagnosis. The main outcome measure was LOS, which was examined by diagnosis between the early and late ECT groups, using a linear regression model with adjustment factors chosen based on univariate analysis.

Results: A strong, significant association was found between early ECT and a shorter LOS (β -28.3, 95 % CI -33.6 to -23.0, p < 0.001), even after accounting for adjustment factors. This association was consistent in all three diagnosis groups: bipolar disorders (β -14.5, 95 % CI -20.1 to -9.0, p < 0.001), major depressive disorder (β -18.2, 95 % CI -27.1 to -9.3, p < 0.001) and psychotic disorders (β -39.0, 95 % CI -46.8 to -31.2, p < 0.001). There was no significant difference in the 30-day readmission rates between the early and late ECT groups trans-diagnostically.

Conclusion: Early ECT is strongly associated with a shorter LOS across a range of diagnostic indications including major depressive disorder, bipolar disorder and schizophrenia. ECT can be considered earlier in treatment-decision algorithms and may offer a reduction in LOS.

Keywords: Bipolar disorder; Electroconvulsive therapy; Length of stay; Major depressive disorder; Schizophrenia.

The article is here.
And from the text:
This is a very nicely presented study with excellent data demonstrating that early ECT is associated with shorter length of hospital stay. The large cohort of patients with psychotic disorders is notable.
Prescribing ECT earlier in the course of an episode, or exacerbation, of illness is an important clinical message, not just to decrease length of stay and resource utilization, but to decrease patient suffering. It just makes good clinical sense, and is something that many of us have been espousing for a long time.
Kudos to our colleagues in Singapore for enriching the ECT literature with these helpful data.


Comments

  1. Phern-Chern TorSeptember 21, 2023 at 8:59 PM

    Thank you for posting our article. We hope this real world data will encourage clincians to prescribe outspatient ect for shorter length of stay and lower direct costs!

    ReplyDelete

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