[Temporary results only in electroconvulsive therapy in therapy-resistant depression; retrospective study].
OBJECTIVE
To evaluate the use and efficacy of electroconvulsive therapy (ECT) in refractory major depression according to DSM-III-R criteria, and to look for factors predicting response in the acute phase and the occurrence of relapse or recurrence after recovery.


METHODS
Retrospective.


METHODS
University Hospital Rotterdam, The Netherlands.


METHODS
Of all patients who received ECT between January 1988 and July 1993 data were collected by study of clinical records and of information by treating physicians after discharge. Every patient was visited once, or received an outpatient department appointment, to obtain informed consent, take a follow-up history and evaluate social functioning by scoring Global Assessment of Functioning and Sickness Impact Profile rating scales.


RESULTS
35 patients received ECT. In clinical practice, the guidelines of the Netherlands Psychiatric Association were not violated; most patients had received adequate pharmacological pretreatment before the decision to start ECT was made. Two patients died in hospital (not from ECT). In the acute phase 25 of the 33 patients still alive upon discharge showed good recovery. Seven of these suffered relapse within six months. The number of patients with a return of depressive symptoms rose to 12 by the end of the first year of follow-up. Sociodemographic variables and treatment characteristics did not appear to influence the result of treatment in the acute phase, nor the occurrence of relapse or recurrence. With less intensive pre- and post-ECT drug treatment the chances of relapse were increased.


CONCLUSIONS
ECT is an effective treatment in the acute phase of a depression. Results after a longer period of follow-up are less satisfactory.
Lemstra
A
A
Academisch Ziekenhuis Rotterdam-Dijkzigt, afd. Psychiatrie.
Leentjens
A F
AF
van den Broek
W W
WW
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003863:Depression / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D016896:Treatment Outcome
D000928:Antidepressive Agents
Slechts tijdelijke resultaten van elektroconvulsietherapie bij therapieresistente depressie; retrospectief onderzoek.