Electroconvulsive therapy (ECT) and Psychiatric rehospitalization rates: a retrospective study
Aneesh Rahangdale1, Jeffrey Ferraro2
1HCA Florida Capital Hospital, 2626 Capital Medical Blvd, Tallahassee, FL, 32308, USA. an463451@ucf.edu.
BMC Psychiatry
|October 31, 2024
Summary
Electroconvulsive therapy (ECT) is linked to higher psychiatric rehospitalization rates and longer stays, especially for severe mental health conditions. This study suggests ECT is used for complex cases, potentially explaining the increased readmission rates.
Area of Science:
- Psychiatry
- Clinical Neuroscience
- Health Services Research
Background:
- Electroconvulsive therapy (ECT) is an established treatment for severe, treatment-resistant psychiatric conditions.
- Despite its efficacy, ECT may be underutilized in clinical practice.
- The impact of ECT on psychiatric rehospitalization rates has not been extensively studied in large-scale American hospital systems.
Purpose of the Study:
- To investigate the association between electroconvulsive therapy (ECT) and psychiatric rehospitalization rates.
- To compare rehospitalization rates within 365 days for patients receiving ECT versus those not receiving ECT.
- To explore subgroup differences in rehospitalization based on diagnosis, treatment duration, sex, and race.
Main Methods:
- Retrospective analysis of inpatient encounters from 2016-2021 at HCA Healthcare Behavioral Health Units.
- Inclusion of adult patients (aged >18) with diagnoses of major depressive disorder, bipolar disorder, schizoaffective disorder, and schizophrenia.
- Comparison of psychiatric rehospitalization rates between ECT recipients and non-recipients, with subgroup analyses and statistical testing (Fisher's Exact Test, Wilcoxon Rank Sum Test).
Main Results:
- A total of 38,109 patients were analyzed, with 637 receiving ECT.
- ECT recipients had a significantly higher rehospitalization rate (37.52%) compared to non-recipients (20.71%, p < 0.0001).
- Higher rehospitalization rates were observed for severe diagnoses, and ECT patients experienced longer rehospitalization lengths of stay (14.53 days vs. 6.54 days).
Conclusions:
- Electroconvulsive therapy (ECT) was associated with increased psychiatric rehospitalization rates and longer lengths of stay.
- The findings suggest ECT is utilized for more complex and severe psychiatric cases, which may contribute to higher rehospitalization.
- Factors such as social support and community ties may also influence rehospitalization patterns in ECT patients.
