Rehospitalization and suicide following electroconvulsive therapy for bipolar depression–A population-based register study

• Background Electroconvulsive therapy (ECT) is effective in bipolar depression, but relapse is common. The aim of the study was (i) to identify prognostic factors (ii) and to determine the impact of pharmacological approaches on the risk for rehospitalization or suicide. Methods This register study analyzed data from individuals treated with inpatient ECT for bipolar depression. Subjects were identified using the Swedish National Patient Register between 2011 and 2014 and the Swedish National Quality Register for ECT. Other national registers provided data on psychopharmacotherapy, socio-demographic factors, and causes of death. The endpoint was the composite of rehospitalization for any psychiatric disorder, suicide attempt or completed suicide (RoS). Cox regression was used to calculate hazard ratios in univariate and multivariate models. Results Data from 1255 patients were analyzed. The mean period of follow-up was 346 days. A total of 29%, 41%, and 52% of patients reached RoS at 3, 6, and 12 months post-discharge. A history of multiple psychiatric admissions, lower age, and post-discharge treatment with antipsychotics or benzodiazepines was associated with RoS. Limitations Indication bias may have affected the results. Conclusions A history of multiple hospital admissions and lower age are key predictors of the composite of rehospitalization or suicide in patients treated with ECT for bipolar depression. Lithium might be effective. By contrast, antipsychotics and benzodiazepines were associated with increased risk, but possibly this finding was influenced by indication bias. © 2017 The Authors

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Nyckelord

alimemazine

antidepressant agent

anxiolytic agent

benzodiazepine derivative

buspirone

central stimulant agent

hydroxyzine

lamotrigine

levomepromazine

lithium

mood stabilizer

neuroleptic agent

prometazine

quetiapine

unclassified drug

valproic acid

adolescent

adult

aged

Article

bipolar depression

bipolar disorder

cause of death

cohort analysis

combination drug therapy

controlled study

demography

electroconvulsive therapy

electroconvulsive therapy unit

electrode

female

follow up

hospital discharge

hospital readmission

human

maintenance therapy

major clinical study

male

mental patient

middle aged

observational study

polypharmacy

priority journal

prognosis

psychopharmacotherapy

register

risk factor

social status

suicide

suicide attempt

very elderly

young adult

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)