title: Relief of expressed suicidal intent by ECT: a consortium for research in ECT study.
abstract: OBJECTIVE
  This study assessed the incidence, severity, and course of expressed suicidal intent in depressed patients who were treated with ECT. The data are from the first phase of an ongoing, collaborative multicenter study, the overall aim of which was to compare continuation ECT with pharmacotherapy in the prevention of relapse after a successful course of ECT.
  
  
  METHODS
  Suicidal intent, as expressed by patients during an interview, was scored at baseline and before each ECT session with item 3 on the 24-item Hamilton Depression Rating Scale in 444 patients with unipolar depression.
  
  
  RESULTS
  One hundred thirty-one patients (29.5%) reported suicidal thoughts and acts (score of 3 or 4) at baseline. Scores decreased to 0 after 1 week (three ECT sessions) in 38.2% of the patients, after 2 weeks (six ECT sessions) in 61.1%, and in 80.9% at the end of the course of treatment.
  
  
  CONCLUSIONS
  Expressed suicidal intent in depressed patients was rapidly relieved with ECT. Evidence-based treatment algorithms for major depressive mood disorders should include dichotomization according to suicide risk, as assessed by interview. For patients at risk, ECT should be considered earlier than at its conventional "last resort" position.
authors.affiliation: University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 183 South Orange Ave., F1436, Newark, NJ 07103, USA. kellner@umdnj.edu
authors.forename: Charles H
authors.initials: CH
authors.lastname: Kellner
authors.forename: Max
authors.initials: M
authors.lastname: Fink
authors.forename: Rebecca
authors.initials: R
authors.lastname: Knapp
authors.forename: Georgios
authors.initials: G
authors.lastname: Petrides
authors.forename: Mustafa
authors.initials: M
authors.lastname: Husain
authors.forename: Teresa
authors.initials: T
authors.lastname: Rummans
authors.forename: Martina
authors.initials: M
authors.lastname: Mueller
authors.forename: Hilary
authors.initials: H
authors.lastname: Bernstein
authors.forename: Keith
authors.initials: K
authors.lastname: Rasmussen
authors.forename: Kevin
authors.initials: K
authors.lastname: O'connor
authors.forename: Glenn
authors.initials: G
authors.lastname: Smith
authors.forename: A John
authors.initials: AJ
authors.lastname: Rush
authors.forename: Melanie
authors.initials: M
authors.lastname: Biggs
authors.forename: Shawn
authors.initials: S
authors.lastname: McClintock
authors.forename: Samuel
authors.initials: S
authors.lastname: Bailine
authors.forename: Chitra
authors.initials: C
authors.lastname: Malur
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D000092864:Suicide Prevention
chemical_list: D008094:Lithium; D009661:Nortriptyline