Patient, treatment, and anatomical predictors of outcome in electroconvulsive therapy: a prospective study

Jeroen A van Waarde, Lucas J B van Oudheusden, Oscar Büno Heslinga, Bastiaan Verwey, Rose C van der Mast, Erik Giltay

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: Baseline predictors of effectiveness and cognitive adverse effects of electroconvulsive therapy (ECT) were prospectively examined.

METHODS: Before and after ECT, the Montgomery-Åsberg Depression Rating Scale (MADRS) and Mini Mental State Examination (MMSE) were assessed. Before ECT, a magnetic resonance imaging of the head was performed. Outcome predictors were investigated using multivariable regression analyses.

RESULTS: Of 83 patients (mean ± SD age, 59.2 ± 15.3 years; 39% men), 28% had a psychotic depressive disorder, 16% had a bipolar depression, 30% had had previous ECT course(s), and 66% used concomitant antipsychotics. Presence of psychotic depression (β = -0.25; P = 0.04) and having had previous ECT (β = -0.35; P = 0.003) predicted lower post-ECT MADRS score. Baseline magnetic resonance imaging characteristics were not predictive of post-ECT MADRS and MMSE scores. The use of concomitant antipsychotics predicted a lower post-ECT MMSE score (β = -0.21; P = 0.02), whereas the presence of bipolar depression at baseline predicted higher post-ECT MMSE score (β = 0.23; P = 0.01). The post-ECT MADRS score seemed to be a confounder for the post-ECT MMSE score (β = -0.20; P = 0.02).

CONCLUSIONS: Effectiveness of ECT was better in the patients with a baseline psychotic depression and those who had had ECT before. Cognitive outcome was better in the patients with baseline bipolar depression but worse in those who used antipsychotics during ECT and those who showed more persistent depressive symptoms after ECT.

Original languageEnglish
Pages (from-to)113-21
Number of pages9
JournalThe journal of ECT
Volume29
Issue number2
DOIs
Publication statusPublished - Jun 2013

Cite this

van Waarde, Jeroen A ; van Oudheusden, Lucas J B ; Heslinga, Oscar Büno ; Verwey, Bastiaan ; van der Mast, Rose C ; Giltay, Erik. / Patient, treatment, and anatomical predictors of outcome in electroconvulsive therapy : a prospective study. In: The journal of ECT. 2013 ; Vol. 29, No. 2. pp. 113-21.
@article{d77135d4df0f4009a0141fe5d7552a17,
title = "Patient, treatment, and anatomical predictors of outcome in electroconvulsive therapy: a prospective study",
abstract = "OBJECTIVES: Baseline predictors of effectiveness and cognitive adverse effects of electroconvulsive therapy (ECT) were prospectively examined.METHODS: Before and after ECT, the Montgomery-{\AA}sberg Depression Rating Scale (MADRS) and Mini Mental State Examination (MMSE) were assessed. Before ECT, a magnetic resonance imaging of the head was performed. Outcome predictors were investigated using multivariable regression analyses.RESULTS: Of 83 patients (mean ± SD age, 59.2 ± 15.3 years; 39{\%} men), 28{\%} had a psychotic depressive disorder, 16{\%} had a bipolar depression, 30{\%} had had previous ECT course(s), and 66{\%} used concomitant antipsychotics. Presence of psychotic depression (β = -0.25; P = 0.04) and having had previous ECT (β = -0.35; P = 0.003) predicted lower post-ECT MADRS score. Baseline magnetic resonance imaging characteristics were not predictive of post-ECT MADRS and MMSE scores. The use of concomitant antipsychotics predicted a lower post-ECT MMSE score (β = -0.21; P = 0.02), whereas the presence of bipolar depression at baseline predicted higher post-ECT MMSE score (β = 0.23; P = 0.01). The post-ECT MADRS score seemed to be a confounder for the post-ECT MMSE score (β = -0.20; P = 0.02).CONCLUSIONS: Effectiveness of ECT was better in the patients with a baseline psychotic depression and those who had had ECT before. Cognitive outcome was better in the patients with baseline bipolar depression but worse in those who used antipsychotics during ECT and those who showed more persistent depressive symptoms after ECT.",
keywords = "Adult, Aged, Brain/anatomy & histology, Cognition/physiology, Cognition Disorders/etiology, Electroconvulsive Therapy/adverse effects, Female, Forecasting, Head/anatomy & histology, Humans, Magnetic Resonance Imaging, Male, Mental Disorders/psychology, Middle Aged, Neuropsychological Tests, Prospective Studies, Psychiatric Status Rating Scales, Psychometrics, Seizures/physiopathology, Treatment Outcome, Young Adult",
author = "{van Waarde}, {Jeroen A} and {van Oudheusden}, {Lucas J B} and Heslinga, {Oscar B{\"u}no} and Bastiaan Verwey and {van der Mast}, {Rose C} and Erik Giltay",
year = "2013",
month = "6",
doi = "10.1097/YCT.0b013e31827e0d02",
language = "English",
volume = "29",
pages = "113--21",
journal = "The journal of ECT",
issn = "1095-0680",
number = "2",

}

Patient, treatment, and anatomical predictors of outcome in electroconvulsive therapy : a prospective study. / van Waarde, Jeroen A; van Oudheusden, Lucas J B; Heslinga, Oscar Büno; Verwey, Bastiaan; van der Mast, Rose C; Giltay, Erik.

In: The journal of ECT, Vol. 29, No. 2, 06.2013, p. 113-21.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Patient, treatment, and anatomical predictors of outcome in electroconvulsive therapy

T2 - a prospective study

AU - van Waarde, Jeroen A

AU - van Oudheusden, Lucas J B

AU - Heslinga, Oscar Büno

AU - Verwey, Bastiaan

AU - van der Mast, Rose C

AU - Giltay, Erik

PY - 2013/6

Y1 - 2013/6

N2 - OBJECTIVES: Baseline predictors of effectiveness and cognitive adverse effects of electroconvulsive therapy (ECT) were prospectively examined.METHODS: Before and after ECT, the Montgomery-Åsberg Depression Rating Scale (MADRS) and Mini Mental State Examination (MMSE) were assessed. Before ECT, a magnetic resonance imaging of the head was performed. Outcome predictors were investigated using multivariable regression analyses.RESULTS: Of 83 patients (mean ± SD age, 59.2 ± 15.3 years; 39% men), 28% had a psychotic depressive disorder, 16% had a bipolar depression, 30% had had previous ECT course(s), and 66% used concomitant antipsychotics. Presence of psychotic depression (β = -0.25; P = 0.04) and having had previous ECT (β = -0.35; P = 0.003) predicted lower post-ECT MADRS score. Baseline magnetic resonance imaging characteristics were not predictive of post-ECT MADRS and MMSE scores. The use of concomitant antipsychotics predicted a lower post-ECT MMSE score (β = -0.21; P = 0.02), whereas the presence of bipolar depression at baseline predicted higher post-ECT MMSE score (β = 0.23; P = 0.01). The post-ECT MADRS score seemed to be a confounder for the post-ECT MMSE score (β = -0.20; P = 0.02).CONCLUSIONS: Effectiveness of ECT was better in the patients with a baseline psychotic depression and those who had had ECT before. Cognitive outcome was better in the patients with baseline bipolar depression but worse in those who used antipsychotics during ECT and those who showed more persistent depressive symptoms after ECT.

AB - OBJECTIVES: Baseline predictors of effectiveness and cognitive adverse effects of electroconvulsive therapy (ECT) were prospectively examined.METHODS: Before and after ECT, the Montgomery-Åsberg Depression Rating Scale (MADRS) and Mini Mental State Examination (MMSE) were assessed. Before ECT, a magnetic resonance imaging of the head was performed. Outcome predictors were investigated using multivariable regression analyses.RESULTS: Of 83 patients (mean ± SD age, 59.2 ± 15.3 years; 39% men), 28% had a psychotic depressive disorder, 16% had a bipolar depression, 30% had had previous ECT course(s), and 66% used concomitant antipsychotics. Presence of psychotic depression (β = -0.25; P = 0.04) and having had previous ECT (β = -0.35; P = 0.003) predicted lower post-ECT MADRS score. Baseline magnetic resonance imaging characteristics were not predictive of post-ECT MADRS and MMSE scores. The use of concomitant antipsychotics predicted a lower post-ECT MMSE score (β = -0.21; P = 0.02), whereas the presence of bipolar depression at baseline predicted higher post-ECT MMSE score (β = 0.23; P = 0.01). The post-ECT MADRS score seemed to be a confounder for the post-ECT MMSE score (β = -0.20; P = 0.02).CONCLUSIONS: Effectiveness of ECT was better in the patients with a baseline psychotic depression and those who had had ECT before. Cognitive outcome was better in the patients with baseline bipolar depression but worse in those who used antipsychotics during ECT and those who showed more persistent depressive symptoms after ECT.

KW - Adult

KW - Aged

KW - Brain/anatomy & histology

KW - Cognition/physiology

KW - Cognition Disorders/etiology

KW - Electroconvulsive Therapy/adverse effects

KW - Female

KW - Forecasting

KW - Head/anatomy & histology

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Mental Disorders/psychology

KW - Middle Aged

KW - Neuropsychological Tests

KW - Prospective Studies

KW - Psychiatric Status Rating Scales

KW - Psychometrics

KW - Seizures/physiopathology

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1097/YCT.0b013e31827e0d02

DO - 10.1097/YCT.0b013e31827e0d02

M3 - Article

VL - 29

SP - 113

EP - 121

JO - The journal of ECT

JF - The journal of ECT

SN - 1095-0680

IS - 2

ER -