Cost-effectiveness of Electroconvulsive Therapy vs Pharmacotherapy/Psychotherapy for Treatment-Resistant Depression in the United States

Ross, E. Clarke; Zivin, Kara; Maixner, Daniel F.

doi:10.1001/jamapsychiatry.2018.0768

Cited by 121 publications

(84 citation statements)

References 71 publications

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“…However, the mechanism of how a controlled seizure leads to reduced depressive symptoms remains poorly understood 1 . Despite popular perception that ECT is antiquated, it can be superior to medication and serves as a vital hope for remission in treatment-resistant cases of depression, bipolar disorder, suicidality and catatonia 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Electroconvulsive Therapy Ictal Outcomes: Duration and Postictal Suppression

Ingram

Weston

et al. 2018

Preprint

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Electroconvulsive therapy (ECT) is an effective and rapid treatment for severe depression, however predictors of therapeutic outcomes remain insufficiently understood. Ictal duration and postictal suppression are two outcomes that may be correlated with patient response, yet patient and treatment variables which may influence these outcomes have not been thoroughly explored. We collected ECT stimulus metrics, EEG parameters, patient demographics, primary diagnosis, and anesthesia type for retrospective ECTs. Univariate and multivariate mixed-effects linear regression models were used to identify variables associated with ictal duration and postictal suppression index. For both outcomes, multivariate models which included all variables resulted in the best fit, reflecting the complex influences of a variety of factors on the ictal response. These results are an important step forward in elucidating patterns in retrospective ECT clinical data which may lead to new clinical knowledge of modifiable factors to optimize ECT treatment outcomes.

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Section: Introductionmentioning

confidence: 99%

Factors Affecting Electroconvulsive Therapy Ictal Outcomes: Duration and Postictal Suppression

Ingram

Weston

et al. 2018

Preprint

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“…and efficacy, ECT remains a stigmatized treatment in psychiatry. 3 Previous studies have found that attitudes toward and knowledge about ECT differ among mental health professionals with more positive attitudes being associated with better knowledge. 11 Studies have found that knowledge improves with targeted education about ECT and that this results in improving attitudes toward ECT.…”

Section: Discussionmentioning

confidence: 99%

Mental health professionals’ attitudes toward and knowledge about electroconvulsive therapy at Weskoppies Hospital, South Africa

Netshilema

Khamker

Sokudela

2018

Perspect Psychiatr Care

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Purpose To investigate the attitudes toward and knowledge of electroconvulsive therapy (ECT) among mental health practitioners. Design and Methods One hundred and eighty‐three participants from five groups of mental health practitioners were included. Anonymous questionnaires were used. Findings Data were analyzed using SPSS version 24.0. Most of the questionnaires were completed by nurses (N = 142; 77.5%). Mean positive attitude scores were statistically different between the five groups, F(4, 178) = 2.63, P = 0.036). Mean knowledge scores between the five groups were statistically significant, H(4) = 30.0, P < 0.0001. Greater knowledge about ECT was associated with more positive attitude toward ECT, r(183) = 0.290, P = 0.01. Practice Implications ECT educational programs need to be provided to all mental health practitioners and the resulting effects on knowledge and attitudes studied.

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“…ECT is approved for these indications by the National Institute for Health and Care Excellence (NICE) and in international guidelines 2122. Additionally, ECT is cost effective and improves quality of life 23. In England 0.43 per 10 000 population are treated annually with ECT, and worldwide about a million people have ECT each year 2425…”

Section: No— Sameer Jauhar and Declan M Mcloughlinmentioning

confidence: 99%

Should we stop using electroconvulsive therapy?

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Cunliffe²,

Jauhar

et al. 2019

BMJ

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Cost-effectiveness of Electroconvulsive Therapy vs Pharmacotherapy/Psychotherapy for Treatment-Resistant Depression in the United States

Cited by 121 publications

References 71 publications

Factors Affecting Electroconvulsive Therapy Ictal Outcomes: Duration and Postictal Suppression

Factors Affecting Electroconvulsive Therapy Ictal Outcomes: Duration and Postictal Suppression

Mental health professionals’ attitudes toward and knowledge about electroconvulsive therapy at Weskoppies Hospital, South Africa

Should we stop using electroconvulsive therapy?

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