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Mirror-Image Comparison of Maintenance Electroconvulsive Treatment Effectiveness in Affective and Psychotic Disorders

Arda Bağcaz1, Koray Başar2

  • 1From the Department of Psychiatry, Başkent University Faculty of Medicine.

The Journal of ECT
|June 14, 2022
PubMed
Abstract

Insights

Maintenance electroconvulsive therapy (mECT) significantly reduces hospitalization frequency and duration in patients with affective and psychotic disorders. This treatment modality proves effective in managing long-term psychiatric conditions.

Area of Science:

  • Psychiatry
  • Neurology
  • Clinical Medicine

Background:

  • Electroconvulsive therapy (ECT) is a recognized treatment for severe psychiatric disorders.
  • Maintenance electroconvulsive therapy (mECT) aims to prevent relapse and recurrence after acute ECT treatment.
  • The effectiveness of mECT in reducing long-term healthcare utilization requires further investigation.

Purpose of the Study:

  • To evaluate the efficacy of maintenance electroconvulsive therapy (mECT) in reducing hospitalization duration and frequency.
  • To assess the impact of mECT on major and minor treatment changes in psychiatric patients.
  • To compare outcomes during mECT treatment versus the period preceding mECT.

Main Methods:

  • A retrospective mirror-image study design was employed, analyzing data from 36 patients with psychotic or affective disorders.
  • Patient medical records were reviewed for two equal-duration periods: before mECT (pre-mECT) and during mECT (post-mECT).
  • Hospitalization duration, number of hospitalizations, and treatment changes were recorded and statistically compared using generalized estimating equation models.

Main Results:

  • Maintenance electroconvulsive therapy (mECT), combined with pharmacotherapy, significantly decreased hospitalization frequency (RR, 0.161; P < 0.001) and duration (RR, 0.123; P < 0.001).
  • A significant reduction in major treatment changes was observed during mECT (RR, 0.522; P = 0.007).
  • Relapse and recurrence rates were comparable between patients with affective and psychotic disorders (26.3% vs 29.4%).

Conclusions:

  • Maintenance electroconvulsive therapy (mECT) is an effective treatment modality for reducing hospitalizations in patients with affective and psychotic disorders.
  • The findings support the continued consideration of mECT as a crucial long-term treatment option following successful acute ECT.
  • Individualized mECT schedules, alongside pharmacotherapy, contribute to improved patient outcomes and reduced healthcare resource utilization.

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