Relapse risk after in-ward electroconvulsive therapy for acute polymorphic psychotic disorder

Area of Science:

• Psychiatry
• Clinical Neuroscience
• Pharmacology

Background:

• Acute polymorphic psychotic disorder (APPD) is a severe psychiatric condition.
• Electroconvulsive therapy (ECT) is an effective treatment for APPD.
• Relapse prevention strategies following ECT for APPD require further investigation.

Purpose of the Study:

• To investigate relapse rates and suicide risk after ECT for APPD.
• To identify prognostic factors associated with relapse and suicide.
• To evaluate the impact of demographic factors, disease characteristics, and relapse preventive treatments on outcomes.

Main Methods:

• Retrospective, register-based study of 97 patients with APPD (ICD-10 F23.0).
• Utilized Swedish national registers (2011-2016) for data collection.
• Employed Cox's regression analysis to determine predictors of readmission and suicide.

Main Results:

• Twenty percent of patients relapsed within the first year post-ECT; relapse rates were lower thereafter.
• Two deaths occurred during follow-up, one by suicide.
• Anxiolytic treatment, lamotrigine, and >4 prior psychiatric admissions were linked to shorter time to relapse, with anxiolytics showing the most robust association.

Conclusions:

• The initial year after discharge presents the highest risk period for APPD relapse.
• A history of numerous psychiatric admissions is associated with increased relapse risk post-ECT.
• The observed associations between anxiolytics, lamotrigine, and relapse require cautious interpretation due to potential indication bias.