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Manic patients receiving ECT in a Brazilian sample.

Fernando M Volpe1, Almir Tavares

  • 1Department of Epidemiology, Escola de Veterinária, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Belo Horizonte, MG 30161-970, Brazil. fmvolpe@terra.com.br

Journal of Affective Disorders
|March 17, 2004
PubMed
Summary

Electroconvulsive therapy (ECT) is predicted by psychotic features, previous admissions, and female gender in manic inpatients. ECT use for mania reduced readmission risk, with similar lengths of stay compared to non-ECT treatment.

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Area of Science:

  • Psychiatry
  • Clinical Neuroscience

Background:

  • Characterization of manic inpatients receiving electroconvulsive therapy (ECT) is lacking.
  • Understanding predictors for ECT use in mania is crucial for treatment optimization.

Purpose of the Study:

  • To identify predictors of electroconvulsive therapy (ECT) use in manic inpatients.
  • To evaluate the impact of ECT on length of stay and readmission risk for mania.

Main Methods:

  • Retrospective chart review of 425 manic/mixed episode admissions (269 patients) from 1996-2000 in a Brazilian private psychiatric hospital.
  • Logistic regression to identify ECT predictors; Cox regression for readmission risk; comparison of length of stay (LOS).

Main Results:

  • Predictors for ECT included: history of previous admission, psychotic features, female gender, marital status, and high psychiatrist caseload. Cardiovascular comorbidity was a negative predictor.

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  • Median LOS after ECT initiation was comparable to non-ECT admissions (12 vs. 13 days).
  • ECT use reduced readmission risk (HR=0.678), while previous admissions increased it (HR=2.320).

    • Conclusions:

    • Psychotic features, violent behavior, and illness chronicity (previous admissions) predict ECT use in mania.
    • ECT did not significantly affect LOS post-initiation but reduced readmission risk.
    • Findings suggest ECT is a valuable intervention for specific manic inpatient profiles, potentially improving long-term outcomes.