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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Depression severity self-assessment to guide relapse potential stratification during maintenance ECT.

Liselotte Gezels1, Linda Van Diermen2, Violette Coppens1

  • 1Scientific Initiative for Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium; Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.

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Summary
This summary is machine-generated.

Self-report depression scales, like the IDS-SR, reliably aid in deciding Maintenance Electroconvulsive Therapy (M-ECT) frequency for major depressive disorder (MDD) patients. This can personalize treatment and reduce relapse rates.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Major Depressive Disorder (MDD) treatment decisions, especially for electroconvulsive therapy (ECT), are critical due to high relapse rates.
  • Maintenance electroconvulsive therapy (M-ECT) is vital for preventing relapse, with symptom-driven approaches gaining traction.
  • The utility of self-report scales alongside clinician assessments in M-ECT decision-making requires further investigation.

Purpose of the Study:

  • To evaluate the reliability of the self-report version of the Inventory of Depressive Symptomatology (IDS-SR) compared to the clinician-rated version (IDS-C) in guiding M-ECT decisions.
  • To assess the concordance between IDS-SR and IDS-C in determining M-ECT frequency for patients with MDD.
  • To explore the potential of self-report measures to optimize personalized M-ECT and reduce resource burden.

Main Methods:

  • A subsample of 96 MDD patients in remission post-acute ECT from the PRASED study were analyzed.
  • Patients were categorized by relapse potential using weekly IDS-C scores to guide M-ECT frequency (0, 1, or 2 sessions).
  • Agreement between IDS-C and IDS-SR was assessed using intraclass correlation coefficients (ICCs) over five monthly assessments during M-ECT.

Main Results:

  • The IDS-SR showed good to excellent agreement with the IDS-C, with ICCs ranging from 0.73 to 0.85.
  • Decision-making outcomes based on both scales were concordant in 81% of cases.
  • The IDS-SR indicated a need for more M-ECT sessions in 16% of cases compared to the IDS-C, suggesting some self-report overestimation.

Conclusions:

  • The IDS-SR is a reliable self-assessment tool for monitoring depression severity during M-ECT, comparable to clinician ratings.
  • Utilizing self-report scales like IDS-SR can reduce the clinician's resource burden, potentially enabling wider implementation of personalized M-ECT.
  • Personalized M-ECT guided by reliable self-report measures may improve patient outcomes by effectively reducing MDD relapse rates.