Who responds to electroconvulsive therapy? A comparison of effective and ineffective forms of treatment.
BACKGROUND
It has been reported that real ECT is more effective than simulated treatment among depressed patients with delusions and/or retardation, and that ECT is not effective among depressed patients who lack these features.


METHODS
In two randomised, double-blind studies, 143 patients with major depression were subtyped regarding psychosis, retardation and agitation. In both studies, low dosage, right unilateral ECT was ineffective compared with other forms of ECT. This report examined whether the depressive subtypes differed in clinical response to the ineffective and effective forms of ECT.


RESULTS
The therapeutic advantage of effective forms of ECT was similar across the depression subtypes. Patients who lacked both psychosis and retardation showed this pattern.


CONCLUSIONS
The findings cast doubt on the utility of these depression subtypes in predicting ECT response. ECT is a viable treatment option for patients with major depression regardless of the presence or absence of psychosis, retardation and/or agitation.
Sobin
C
C
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, USA.
Prudic
J
J
Devanand
D P
DP
Nobler
M S
MS
Sackeim
H A
HA
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D000368:Aged; D003702:Delusions / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011596:Psychomotor Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome