title: Impact of ECT on duration of hospitalizations for mania.
abstract: OBJECTIVE
  To assess the impact of the use of electroconvulsive therapy (ECT) on the length of hospital stay of manic patients.
  
  
  METHODS
  We reviewed 425 consecutive admissions of 269 patients with manic or mixed affective episodes in a Brazilian private psychiatric hospital. Lengths of stay (LOSs) were compared for admissions in which ECT versus exclusive pharmacologic treatment was administered. A mixed model for repeated measures was developed to control for intraindividual correlations and potential demographic, clinical, and treatment confounder variables. The analyses were repeated using LOS minus the time until ECT was first given in each admission (LOS-tECT) as the response variable.
  
  
  RESULTS
  Use of ECT was associated with longer LOS than exclusive pharmacologic treatment (18.78 versus 12.51 days; p < 0.001). This effect disappeared when using LOS-tECT as the response variable (11.57 versus 12.16 days; p = 0.530). Violent behavior and in-hospital use of antipsychotics and benzodiazepines were also associated with longer LOS, whereas being married was associated with shorter LOS.
  
  
  CONCLUSIONS
  The use of ECT during hospitalizations for mania was associated with longer lengths of stay. This effect was caused mostly by delays in commencing ECT treatments rather than by the duration of treatment itself.
authors.affiliation: Department of Psychiatry, Santa Maria Hospital, Belo Horizonte, MG, Brazil. fmvolpe@terra.com.br
authors.forename: Fernando Madalena
authors.initials: FM
authors.lastname: Volpe
authors.forename: Almir
authors.initials: A
authors.lastname: Tavares
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008393:Marriage; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014754:Violence