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Electroconvulsive t...
Electroconvulsive therapy in the maintenance phase of psychotic unipolar depression
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- Al-Wandi, Ahmed, 1990- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Landén, Mikael, 1966 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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- Nordenskjöld, Axel, 1977- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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(creator_code:org_t)
- John Wiley & Sons, 2024
- 2024
- English.
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In: ACTA PSYCHIATRICA SCANDINAVICA. - : John Wiley & Sons. - 0001-690X .- 1600-0447.
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Abstract
Subject headings
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- Objective: To determine whether the rates of readmissions and suicide vary in psychotic unipolar depression based on whether patients receive maintenance electroconvulsive therapy (M-ECT) following the initial series of ECT, and to examine if there is an age-dependent association. Methods: We used Swedish national registries to identify hospitalized patients with psychotic unipolar depression, treated 2008-2019 who received ECT during their hospital stay. The patients who received subsequent M-ECT within 14 days after discharge were compared with those who did not. The primary composite outcome was time to readmission due to a psychiatric disorder, suicide attempt, or suicide within 2 years from discharge. Data were analyzed using Cox regression adjusted for previous psychiatric admissions, age, sex, comorbidity, and pharmacological treatment. We also conducted a within-individual analysis using the sign-test, with patients having >= 1 hospital episode followed by M-ECT and >= 1 hospital episode without M-ECT. Results: A total of 1873 patients were included, of which 130 received M-ECT. There was no statistically significant group difference regarding the primary outcome in the whole sample. However, when stratified by age, there was a significant difference in favor of M-ECT for patients >65 years (adjusted hazard ratio 0.55, 95% confidence interval 0.35-0.87). The within-individual analysis, including 46 patients, significantly favored M-ECT. Conclusion: M-ECT was not associated with a differential risk of the composite of readmission and suicide in psychotic depression. Among patients >65 years, M-ECT was significantly associated with a decreased risk of the outcome. The possibility of residual confounding cannot be excluded.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- electroconvulsive therapy
- maintenance
- psychotic depression
- readmission
- relapse
- Electroconvulsive therapy
Publication and Content Type
- ref (subject category)
- art (subject category)
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