These findings add to an emerging story of reduced efficiency of UB-RUL versus BL electrode placement for an index course of ECT for the treatment of depression.
Multidomain pre-ECT cognitive assessment is feasible and well-tolerated in most patients. Cognitive performance did not worsen after ECT in people with psychotic depression and improved on some measures. The degree of cognitive improvement seems to be directly related to the improvement in negative symptoms.
Prior reports of limited receipt of EBPIs are reinforced. There is patchy evidence for targeting of EBPIs to those who might benefit most. Service characteristics contribute more to the prediction of receipt than clinical characteristics. Greater implementation effort and better targeting are required to bridge evidence-practice gaps, including improved evidence-based practice literacy among professionals and needs-based service re-design to improve provision and optimise consumer outcomes.
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