Improvements in Health-Related Quality of Life With Electroconvulsive Therapy

Giacobbe, Peter; Rakita, Uros; Penner-Goeke, Kirsten; Feffer, Kfir; Flint, Alastair J.; Kennedy, Sidney H.; Downar, Jonathan

doi:10.1097/yct.0000000000000486

Cited by 22 publications

(11 citation statements)

References 34 publications

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“…Electroconvulsive therapy (ECT) is a high-value treatment for psychiatric illnesses that provides great response rates [1][2][3] in a quick manner [4] and improves patient healthrelated quality of life [5].…”

Section: Introductionmentioning

confidence: 99%

Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions

et al. 2021

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In electroconvulsive therapy (ECT), ictal characteristics predict treatment response and can be modified by changes in seizure threshold and in the ECT technique. We aimed to study the impact of ECT procedure-related variables that interact during each session and might influence the seizure results. Two hundred and fifty sessions of bilateral ECT in forty-seven subjects were included. Seizure results were evaluated by two different scales of combined ictal EEG parameters (seizure quality index (SQI) and seizure adequacy markers sum (SAMS) scores) and postictal suppression rating. Repeated measurement regression analyses were performed to identify predictors of each session’s three outcome variables. Univariate models identified age, physical status, hyperventilation, basal oxygen saturation, days between sessions, benzodiazepines, lithium, and tricyclic antidepressants as predictors of seizure quality. Days elapsed between sessions, higher oxygen saturation and protocolized hyperventilation application were significant predictors of better seizure quality in both scales used in multivariate models. Additionally, lower ASA classification influenced SQI scores as well as benzodiazepine use and lithium daily doses were predictors of SAMS scores. Higher muscle relaxant doses and lower applied stimulus intensities significantly influenced the postictal suppression rating. The study found several modifiable procedural factors that impacted the obtained seizure characteristics; they could be adjusted to optimize ECT session results.

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Section: Introductionmentioning

confidence: 99%

Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions

et al. 2021

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“…Natürlich sollte nicht nur die Abnahme der Depressivität, sondern auch der Gewinn an Lebensqualität Ziel einer antidepressiven Therapie sein. Eine diesbezügliche Metaanalyse zeigte hohe Effektstärken für den Zugewinn an Lebensqualität durch eine EKT bei depressiven Störungen (26). Aus diesem Grund wird in der nationalen Versorgungsleitlinie (S3-Leitlinie) die Behandlung der therapieresistenten depressiven Episode mittels EKT mit dem höchsten Evidenzgrad empfohlen.…”

Section: Therapieresistente Depressionenunclassified

EKT bei depressiven Störungen

Sartorius¹

2018

Nervenheilkunde

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ZusammenfassungDie Elektrokrampftherapie oder Elektrokonvulsionstherapie (EKT) gilt bei der Behandlung depressiver Störungen nicht nur als Routinetherapie, sondern bei schweren oder therapieresistenten oder wahnhaften Depressionen als Therapie der Wahl. Aufgrund bestehender Vorurteile und Stigmatisierungen ist die EKT in dieser Indikation in Deutschland im Vergleich zu anderen Industrieländern immer noch massiv unterrepräsentiert, obwohl sie mittlerweile ein modernes, sicheres, nebenwirkungsarmes und gut verträgliches Verfahren darstellt. In diesem Übersichtsartikel werden auch die Indikationen für schizodepressive Episoden, depressive Episoden mit führender stuporös-katatoner Symptomatik oder Depressionen mit vorbestehenden kognitiven Störungen oder begleitenden Parkinson-Syndromen diskutiert. Ebenso wird ein kurzer Überblick über die Durchführung einer EKT in Bezug auf Vorbereitung, Narkose und Stimulation, Überwachung, technische Parameter und Übergang in eine Erhaltungs-EKT gegeben.

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“…Empirical data concerning the therapeutic effects of ECT are impressive. Meta-analyses of ECT for depression and schizophrenia support robust treatment effects with odds ratios between three and four and excellent remission rates of up to 75% even in treatment resistance, improving health-related quality of life (Giacobbe et al, 2018;Bahji et al, 2019;Grover et al, 2019;Mutz et al, 2019;Sinclair et al, 2019;Chen et al, 2021;Li et al, 2021). Independent of its antidepressant effects, ECT also has a significant anti-suicidal effect (Kellner et al, 2005).…”

Section: Introductionmentioning

confidence: 96%

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

Hajak

Hajak²,

Ziegelmayer³

et al. 2021

Front. Psychol.

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Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression. Its clinical use is mainly limited by historical objections and the concern about unwanted adverse effects (AEs), including serious and potentially life-threatening adverse events (pLTAEs), induced either by ECT or by anesthesia. Objective risk estimation is, therefore, a decisive factor in determining an indication for ECT.Methods: This paper presents a retrospective analysis of 3-year safety protocols and patient files of 157 patients who received a total of 3,106 ECT applications in a psychiatric inpatient setting at a psychiatric community hospital. This patient group comprises 5.3% of inpatients admitted with comparable diagnoses. Adverse events were analyzed from standardized safety protocols and patient files with a focus on pLTAEs.Results: Adverse events were reported for 30 (19.1%) of the 157 participants during 39 (6.1%) of 641 hospital stays. Serious pLTAEs occurred during three electroconvulsive stimulations in three patients, who needed action through the administration of medication or mechanical respiration. No patient suffered permanent damage to health, and no patient died. The incidence of these and other AEs was independent of sex, age, and diagnosis of patients, and anesthesia medication. Minor AEs occurred more often with higher stimulus doses and an increasing number of treatments.Conclusion: The low incidence rate of 0.097% of serious pLTAEs that require medical action may allow the conclusion that ECT is a rather safe treatment when performed in a controlled setting. The beneficial risk profile of ECT performed in the standard care of psychiatric hospitals suggests a more generous indication of this treatment method. We recommend that ECT facilities collect individual safety data to allow a reliable judgment of their institutional ECT risk profile.

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Improvements in Health-Related Quality of Life With Electroconvulsive Therapy

Cited by 22 publications

References 34 publications

Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions

Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions

EKT bei depressiven Störungen

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

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