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Seizure Duration and Electroconvulsive Therapy in Major Depressive Disorder

Gillving, Cecilia, 1999- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden,Orebro Univ, Sweden
Ekman, Carl Johan (författare)
Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm, Sweden
Hammar, Asa (författare)
Univ Bergen, Norway; Lund Univ, Sweden,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Clinical Sciences, Division of Adult Psychiatry Faculty of Medicine, Lund University, Lund, Sweden
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Landen, Mikael (författare)
Karolinska Inst, Sweden; Gothenburg Univ, Sweden,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
Lundberg, Johan (författare)
Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm, Sweden
Rad, Pouya Movahed (författare)
Lund Univ, Sweden,Department of Clinical Sciences, Division of Adult Psychiatry Faculty of Medicine, Lund University, Lund, Sweden
Nordanskog, Pia (författare)
Linköpings universitet,Centrum för social och affektiv neurovetenskap,Medicinska fakulteten,Region Östergötland, Psykiatriska kliniken i Linköping,Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Psychiatry, Region Östergötland, Linköping, Sweden
von Knorring, Lars (författare)
Uppsala Univ, Sweden,Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
Nordenskjöld, Axel, 1977- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden,Orebro Univ, Sweden
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 (creator_code:org_t)
AMER MEDICAL ASSOC, 2024
2024
Engelska.
Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 7:7
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
https://urn.kb.se/re...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • IMPORTANCE Electroconvulsive therapy (ECT), wherein a generalized epileptic seizure is induced, is a treatment for major depressive disorder (MDD). Currently, it is unclear whether there is an association between seizure length and treatment outcome. OBJECTIVE To explore the association between seizure duration, potential confounding variables, and ECT treatment outcome. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study obtained data from the Swedish National Quality Register for ECT. Patients treated for unipolar MDD with unilateral electrode placement between January 1, 2012, and December 31, 2019, were included. The electroencephalographic (EEG) seizure duration from the first ECT treatment session for each patient was used for analysis. Data analyses were performed between March 2021 and May 2024. MAIN OUTCOMES AND MEASURESThe primary outcome was remission, defined as a cutoff score of less than 10 points on the self-assessment version of the Montgomery-& Aring;sberg Depression Rating Scale within 1 week after ECT. Multivariate logistic regression analysis was performed to calculate odds ratios (ORs) between different seizure duration groups. Furthermore, the associations between concomitant use of pharmacological treatments, seizure duration, and remission rate were explored. RESULTS Among the 6998 patients included, 4229 (60.4%) were female and the mean (SD) age was 55.2 (18.6) years. Overall, 2749 patients (39.3%) achieved remission after ECT. Patients with EEG seizure duration of 60 to 69 seconds had the highest remission rates compared with patients with seizure duration of less than 20 seconds (OR, 2.17; 95% CI, 1.63-2.88; P < .001). Anticonvulsant medications were associated with shorter seizure duration (eg, lamotrigine: beta coefficient [SE], -6.02 [1.08]; P < .001) and lower remission rates (eg, lamotrigine: adjusted OR, 0.67; 95% CI, 0.53-0.84; P < .001). CONCLUSIONS AND RELEVANCE This study found an association between seizure length and remission from MDD. Use of anticonvulsant medication during ECT was associated with shorter seizure duration and lower remission rates after ECT.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

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