Introduction
Methods
Participants
Instruments
Electroconvulsive therapy and measurement seizure thresholds
Statistical analyses
Results
Patient and treatment characteristics
n (%); or mean ± SDd; or median; IQRe
| |
---|---|
Patient characteristics
| |
Male gender | 34 (37.4) |
Age, in years | 59.1 ± 15.0 |
Body mass index, in kg/m2
| 24.7; 22.7–27.3 |
CIRS scorea
| 22.0 ± 3.8 |
Diagnostic category, according to axis 1 of DSM-IV-Rc: | |
Depressive disorder without psychotic features | 50 (54.9) |
Depressive disorder with psychotic features | 24 (26.4) |
Bipolar disorder, depressive episode | 14 (15.4) |
Other disordersb
| 3 (3.3) |
Documented or clinically suspected personality disorder present, according to axis 2 of DSM-IV-R | 27 (29.7) |
MADRSf score at baseline (n = 88) | 36.2 ± 8.6 |
MMSEg score at baseline (n = 86) | 28; 25–29 |
Treatment characteristics
| |
Had previous course(s) of ECT | 28 (30.8) |
Days between last ECT and index ECT (n = 28) | 646; 202–1,393 |
Use of seizure threshold influencing concomitant pharmacotherapy: | |
Benzodiazepines | 54 (59.3) |
Antiepileptics | 7 (7.7) |
Antidepressants | 52 (57.1) |
Antipsychotics | 58 (63.7) |
Electrode placement is bifrontotemporal at first titration session | 28 (30.8) |
Initial seizure threshold, in millicoulombs | 60.9 ± 42.3 |
Dynamic impedance at first titration session, in Ω | 275.5 ± 59.5 |
Etomidate dose at first titration session, in mg | 20; 18–22 |
Succinylcholine dose at first titration session, in mg | 80; 75–100 |
Total number of ECT sessionsh (n = 86) | 17.9 ± 7.4 |
Switch from right unilateral to bifrontotemporal electrode placement during coursei (n = 63) | 33 (52.4) |
Predictors for IST
Univariate correlates of IST at baseline | Multivariate correlates of ISTa at baseline | Multivariate correlates of STa during follow-up | ||||
---|---|---|---|---|---|---|
β-coefficient |
P value | β-coefficient |
P value | β-coefficient |
P value | |
Patient characteristics
| ||||||
Male gender | −0.043 | 0.682 | ||||
Age, in years | 0.466 | <0.001 | 0.238 | 0.033 | 0.279 | 0.009 |
Body mass index, in kg/m2
| −0.156 | 0.143 | ||||
CIRS scored
| 0.385 | <0.001 | 0.154 | 0.131 | 0.127 | 0.227 |
Diagnostic category, according to axis 1 of DSM-IV-Rf
| ||||||
Depressive disorder without psychotic features | −0.064 | 0.544 | ||||
Depressive disorder with psychotic features | 0.030 | 0.781 | ||||
Bipolar disorder, depressive episode | 0.076 | 0.476 | ||||
Other disorderse
| −0.046 | 0.664 | ||||
Documented or clinically suspected personality disorder present, according to axis 2 of DSM-IV-R | −0.134 | 0.207 | ||||
MADRSb score at baseline | 0.082 | 0.450 | ||||
MMSEc score at baseline | −0.331 | 0.002 | −0.045 | 0.641 | 0.058 | 0.549 |
Treatment characteristics
| ||||||
Had previous course(s) of ECT | 0.346 | 0.001 | 0.059 | 0.579 | −0.052 | 0.564 |
Days between last ECT and index ECT | −0.064 | 0.746 | ||||
Use of seizure threshold influencing concomitant pharmacotherapy | ||||||
Benzodiazepines | 0.033 | 0.758 | ||||
Antiepileptics | 0.027 | 0.803 | ||||
Antidepressants | 0.084 | 0.431 | ||||
Antipsychotics | −0.112 | 0.289 | ||||
Electrode placement is bifrontotemporal | 0.546 | <0.001 | 0.424 | <0.001 | 0.348 | <0.001 |
Dynamic impedance | −0.248 | 0.018 | −0.082 | 0.344 | −0.107 | 0.062 |
Etomidate dose | −0.084 | 0.427 | ||||
Succinylcholine dose | −0.295 | 0.005 | −0.071 | 0.452 | −0.056 | 0.376 |
Predicting for ST change during the ECT course
RUL placement | BL placement |
P value for comparing median ST change in RUL versus BLb
| |||||||
---|---|---|---|---|---|---|---|---|---|
n
| Mean ± SD | ST increase present (%) | Median ST change versus baseline; IQR |
n
| Mean ± SD | ST increase present (%) | Median ST change versus baseline; IQR | ||
Characteristic
| |||||||||
STa at initial session | 63 | 45.6 ± 16.8 | 28 | 95.4 ± 59.5 | |||||
ST at 6th session | 49 | 53.0 ± 25.3 | 9 (18.4) | 0; 0–0 | 37 | 98.1 ± 77.9 | 11 (29.7) | 0; 0–25.2 | 0.953 |
ST at 12th session | 22 | 52.7 ± 25.7 | 3 (13.6) | 0; 0–0 | 45 | 98.6 ± 103.0 | 24 (53.3) | 25.2; 0–50.4 | 0.019 |
ST at 18th session | 8 | 47.3 ± 25.0 | 2 (25.0) | 0; 0–18.9 | 35 | 94.9 ± 55.2 | 22 (62.9) | 25.2; 0–75.6 | 0.055 |
ST at 24th session | 3 | 50.4 ± 0.0 | 2 (66.7) | 25.2; 0–25.2 | 12 | 100.8 ± 52.6 | 8 (66.7) | 50.4; 0–75.6 | 0.339 |