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Sex-specifics of ECT outcome.

M A J T Blanken1, M L Oudega2, A W Hoogendoorn3

  • 1Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands.

Journal of Affective Disorders
|January 12, 2023
PubMed
Summary

Electroconvulsive therapy (ECT) shows equal effectiveness for major depressive disorder (MDD) in both men and women. However, a shorter duration of the index episode predicts better ECT outcomes specifically in women.

Keywords:
ECTElectroconvulsive therapyMajor depressive disorderPhenotypePredictorSexSex-specific

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Medicine

Background:

  • Major depressive disorder (MDD) exhibits known sex differences.
  • Electroconvulsive therapy (ECT) is a highly effective treatment for severe MDD.
  • Understanding sex-specific differences in ECT outcomes can refine clinical guidelines.

Purpose of the Study:

  • To investigate sex differences in electroconvulsive therapy (ECT) outcomes for major depressive disorder (MDD).
  • To identify predictors of ECT treatment success, considering potential sex-specific factors.

Main Methods:

  • Analysis of clinical data from 500 patients with MDD across 20 independent sites (Global ECT-MRI Research Collaboration).
  • Assessment of depression severity using validated scales before and after ECT.
  • Logistic regression analysis to identify predictors of remission, defined as HAM-D score ≤ 7.

Main Results:

  • ECT remission rates were similar between sexes: 48.0% for women and 45.7% for men.
  • A shorter duration of the index depressive episode emerged as a significant sex-specific predictor for ECT remission in women.
  • Confidence intervals for predictive margins showed overlap between men and women.

Conclusions:

  • Electroconvulsive therapy (ECT) demonstrates comparable efficacy for major depressive disorder (MDD) in both women and men.
  • Shorter index episode duration is an additional predictor of ECT remission specifically in women.
  • Further research is warranted to confirm the overlapping nature of predictive margins for sex-specific ECT outcomes.