title: Maintenance Electroconvulsive Therapy in Severe Bipolar Disorder: A Retrospective Chart Review.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of continuation and maintenance electroconvulsive therapy (C/M-ECT) in patients with bipolar or schizoaffective disorder.
  
  
  METHODS
  We reviewed the charts of all patients diagnosed with a bipolar or schizoaffective disorder treated with C/M-ECT from August 2009 until December 2013. We gathered demographic data and treatment variables (electrode placement, stimulus dose, and concomitant use of medication; number of C/M-ECT sessions; and number of new ECT courses). Primary outcome measure was the number of hospitalization days during C/M-ECT as compared with an equal period before starting the index course.
  
  
  RESULTS
  Twenty women (64.5%) and 11 men (35.5%) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar disorder (n = 22, 71%) or schizoaffective disorder (n = 9, 29%) received C/M-ECT. The mean (SD) age was 51.23 (14.86; range, 28-74) years. Before the start of the index ECT, patients had a mean of 290 hospitalization days (248.4 days, full hospitalization; 41.6 days, partial hospitalization), whereas during C/M-ECT, they had a mean of 214.7 hospitalization days (85.4 days, full hospitalization; 129.3 days, partial hospitalization). The number of readmissions before ECT was 2.13, whereas during C/M-ECT, it decreased to 1.48. Only the decrease in number of full hospitalization days was significant. Most patients (n = 23, 74.19%) needed an acute course of ECT during M-ECT.
  
  
  CONCLUSIONS
  Maintenance ECT seems to significantly reduce the number of full hospitalization days in patients with severe bipolar or schizoaffective disorder.
authors.affiliation: From the *University Psychiatric Center KU Leuven, Leuven; †Department of Psychiatry, Antwerp University Hospital, Antwerp; ‡Department of Old-Age Psychiatry, §ECT Department, and ∥Mood Disorders Programme, University Psychiatric Center KU Leuven, Leuven; and ¶Psychiatric Hospital Sint-Annendael, Diest, Belgium.
authors.forename: Laura
authors.initials: L
authors.lastname: Santos Pina
authors.forename: Filip
authors.initials: F
authors.lastname: Bouckaert
authors.forename: Jasmien
authors.initials: J
authors.lastname: Obbels
authors.forename: Martien
authors.initials: M
authors.lastname: Wampers
authors.forename: Wim
authors.initials: W
authors.lastname: Simons
authors.forename: Sabien
authors.initials: S
authors.lastname: Wyckaert
authors.forename: Pascal
authors.initials: P
authors.lastname: Sienaert
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome