Predictors of response to electroconvulsive therapy in patients with unipolar and bipolar depression

Okur H., Predictors of Response to Electroconvulsive Therapy in Patients with Unipolar and Bipolar Depression. Hacettepe University Faculty of Medicine, Department of Psychiatry, Dissertation Thesis, Ankara, 2018. The aim of this study is to identify the predictors of the response, remission, maintanance of the remission at 3-months and relapse in unipolar and bipolar depression patients who were treated with ECT. The study was conducted at Hacettepe University Faculty of Medicine Department of Psychiatry, in a naturalistic design which included Unipolar and Bipolar Depression patients who were treated with ECT between January 2017 and March 2018. The social and demographic characteristics of the participants were collected and the diagnoses were confirmed with SCID-I (Structured Clinical Interview for DSM-IV Axis I Disorders). The severity of depression was assessed with Montgomery-Asberg Depression Scale (MADRS) and Clinical Global Impression (CGI) and the treatment resistance via Antidepressant Treatment History Form (ATHF). The patients were evaluated before the ECT, each week during the ECT course, immediately and 12 weeks after the last ECT session. A total of 31 patients were included into the study, 18 of whom were diagnosed as unipolar and 13 as bipolar depression (F:M=24:7). The treatment duration varied between 3 and 8 weeks (6-16 sessions). During the follow-up, two patients left the study and at the time of this dissertation, 7 patients had not yet completed the protocol, therefore data of a total of 22 patients are presented for the 12th week assessment.The mean age and the age of onset in the responder group were higher than the non-responders albeit not-statistically significant (p=0.082 and 0.074, respectively). Those who maintain remission at 12 weeks after the last session were marginally older (p=0.058). Non-response rates at 12 weeks after the last session were significantly higher in women (p=0.005). In patients with psychotic symptoms, there was a trend towards less relapse at 12 weeks (p=0.062). In our study, older patients and those with later age-of-onset had better response to ECT and male patients and patients with psychotic symptoms had less relapse at 12 weeks. It is possible that the association between the age and the age-of-onset and treatment response could not reach statistical significance due to the small sample size. Keywords: Electroconvulsive therapy (ECT), depression, remission, response, relapse, predictors Keywords: Electroconvulsive therapy (ECT), depression, remission, response, relapse, predictors