Predictors of response to electro-convulsive therapy in major depression

This study analyses the predictors of response to electro-convulsive therapy in major depression The significance of the initial response to ECT as a predictor of outcome was also studied. 30 patients who met the diagnostic catena for major depression, single episode, as defined by DSM-IIIR were treated with 6-10 ECT sessions. Patients who had shown overall improvement by 50% or more on the Hamilton Depression Rating Scale (HDRS) were considered responders. 19 (63.33%) patients were responders while 11 (36.67%) patients were non-responders. These two groups differed significantly with regard to presence/absence of a delusion, diurnal variation of mood, and baseline HDRS score for hypochondriasis. Early improvement in depression was found to have a positive correlation with overall improvement in depression after the full course of ECT. Multiple linear regression analysis showed that approximately 56% of variability m outcome could be explained by the variables hypochondriasis, delusion and diurnal variation of mood taken together. A logistic regression model nosed on these 3 variables classified 83.3% of the patients correctly. The implications of these findings are discussed.