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The Northwick Park Ect Trial: Predictors of Response to Real and Simulated Ect

Clinical Research Centre, Division of Psychiatry

Published online by Cambridge University Press:  29 January 2018

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Summary

The clinical characteristics of 70 patients included in the Northwick Park ECT trial of real against simulated ECT were analysed to identify predictors of response to the two treatments. The initial agitated/deluded/retarded substratification, the initial assessment of delusions by PSE, the individual items and factors derived from the Hamilton depression scale were all evaluated, together with six scales previously held to predict response to ECT and the individual items of these scales. The limited size of the sample does not allow firm conclusions, but the most significant and only consistent predictor of response to real ECT appeared to be the presence of delusions. The features of ‘endogenous depression’ did not in themselves appear to predict response to real ECT. The findings are discussed in relation to the viewpoint that delusional depression may be a specific entity which is relatively resistant to tricyclic antidepressants but responsive to electroconvulsive shock.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 144 , Issue 3 , March 1984 , pp. 227 - 237
Copyright
Copyright © 1984 The Royal College of Psychiatrists 

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References

Anderson, E. W. (1936) Prognosis of the depressions of later life. Journal of Mental Science, 82, 559–88.Google Scholar
Angst, J. (1961) A clinical analysis of the effects of Tofranil in depression. Psychopharmacologia, 2, 381–407.CrossRefGoogle ScholarPubMed
APA (1978) Electroconvulsive Therapy: Task Force Report 14. Washington D.C.: American Psychiatric Association.Google Scholar
Avery, D. & Lubrano, A. (1979) Depression treated with imipramine and ECT: the De Carolis study reconsidered. American Journal of Psychiatry, 136, 559–62.Google Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depression syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–74.CrossRefGoogle Scholar
Charney, D. S. & Nelson, J. C. (1981) Delusional and non-delusional unipolar depression: further evidence for distinct subtypes. American Journal of Psychiatry, 138, 328–333.Google Scholar
Crow, T. J. & Johnstone, E. C. (1979) Electroconvulsive therapy—efficacy, mechanism of action and adverse effects. In Psychopharmacology of Affective Disorders, eds Paykel, E. S. & Coppen, A. Oxford: Oxford University Press.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, A., Winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.CrossRefGoogle ScholarPubMed
Freeman, C. P. L., Basson, J. V. & Crichton, A. (1978) Double-blind controlled trial of electroconvulsive therapy (ECT) and simulated ECT in depressive illness. Lancet, i, 738–40.Google Scholar
Friedberg, J. (1977) Shock treatment, brain damage and memory loss: a neurological perspective. American Journal of Psychiatry, 134, 1010–14.Google Scholar
Friedman, C., De Mowbray, M. S. & Hamilton, V. (1961) Imipramine (Tofranil) in depressive states. Journal of Mental Science, 107, 948–53.CrossRefGoogle ScholarPubMed
Frith, C. D., Stevens, M., Johnstone, E. C., Deakin, J. F. W., Lawler, P. & Crow, T. J. (1982) The effects of ECT and depression on various aspects of memory. British Journal of Psychiatry, 142, 610–17.Google Scholar
Glassman, A. H., Kantor, S. J. & Shostak, M. (1975) Depression, delusions and drug response. American Journal of Psychiatry, 132, 716–19.Google Scholar
Glassman, A. H. & Roose, S. P. (1981) Delusional depression. A distinct clinical entity? Archives of General Psychiatry, 38, 424–7.Google Scholar
Greenblatt, M., Grosser, G. H. & Wechsler, H. (1964) Differential response of hospitalised depressed patients to somatic therapy. American Journal of Psychiatry, 120, 935–43.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–96.Google Scholar
Hamilton, M. (1974) Prediction of response to ECT in depressive illness. In Classification and Prediction of Outcome of Depression, ed. Angst, J. Stuttgart: Schlattauer Verlag.Google Scholar
Hamilton, M. & White, J. M. (1959) Clinical syndromes in depressive states. Journal of Mental Science, 105, 985–98.Google Scholar
Herrington, R. N., Bruce, A., Johnstone, E. C. & Lader, M. H. (1974) Comparative trial of L-tryptophan and ECT in severe depressive illness. Lancet, ii, 731–4.Google Scholar
Hobson, R. F. (1953) Prognostic factors in electroconvulsive therapy. Journal of Neurology, Neurosurgery and Psychiatry, 16, 275–81.Google Scholar
Hoch, A. & MacCurdy, J. T. (1922) The prognosis of involution melancholia. Archives of Neurology and Psychiatry, 7, 1–17.Google Scholar
Hordern, A., Holt, N. F., Burt, C. G. & Gordon, W. F. (1963) Amitriptyline in depressive states. Phenomenology and prognostic considerations. British Journal of Psychiatry, 109, 815–25.CrossRefGoogle ScholarPubMed
Huston, P. E. & Locher, L. M. (1948) Manic–depressive psychosis. Archives of Neurology and Psychiatry, 60, 37–48.Google Scholar
Jarvie, H. F. & Glas, M. B. (1950) On atypicality and the depressive state. Journal of Mental Science, 96, 208–25.Google Scholar
Johnstone, E. C., Deakin, J. F. W., Lawler, P., Frith, C. D., Stevens, M., McPherson, K. & Crow, T. J. (1980) The Northwick Park ECT Trial. Lancet, ii, 1317–20.Google Scholar
Johnstone, E. C., Deakin, J. F. W., Lawler, P., Frith, C. D., Stevens, M., McPherson, K. & Crow, T. J. (1982) Benzodiazepines and the effectiveness of ECT. British Journal of Psychiatry, 141, 314–15.Google Scholar
Kantor, S. J. & Glassman, A. H. (1977) Delusional depressions: natural history and response to treatment. British Journal of Psychiatry, 131, 351–60.Google Scholar
Kendell, R. E. (1968) The Classification of Depressive Illnesses. London: Oxford University Press.Google Scholar
Kendell, R. E. (1981) The present status of electroconvulsive therapy. British Journal of Psychiatry, 139, 265–83.Google Scholar
Lambourn, J. & Gill, D. (1978) A controlled comparison of simulated and real ECT. British Journal of Psychiatry, 133, 514–19.Google Scholar
Lewis, A. J. (1934) Melancholia: clinical survey of depressed states. Journal of Mental Science, 80, 277–378.Google Scholar
Lewis, A. J. (1936) Melancholia: prognostic study and case material. Journal of Mental Science, 82, 488–558.CrossRefGoogle Scholar
Medical Research Council (1965) Report by Clinical Psychiatry Committee—Clinical trial of the treatment of depressive illness. British Medical Journal, 1, 881–6.Google Scholar
Mendels, J. (1967) The prediction of response to electroconvulsive therapy. American Journal of Psychiatry, 124, 153–9.Google Scholar
Morrissey, J. P., Burton, N. M. & Steadman, H. J. (1979) Developing an empirical base for psycho-legal policy analyses of ECT: a New York state survey. International Journal of Law and Psychiatry, 2, 99–111.Google Scholar
Nelder, J. (1975) Generalised Linear Models. Oxford: Numerical Logarithms Group.Google Scholar
Nelson, J. C. & Bowers, M. B. (1978) Delusional unipolar depression: description and drug response. Archives of General Psychiatry, 35, 1321–8.Google Scholar
Paykel, E. S., Myers, L. K., Dienelt, M. N., Klerman, G. L., Lindenthal, L. J. & Pepper, M. P. (1969) Life events and depression. Archives of General Psychiatry, 21, 752–60.Google Scholar
Pippard, J. & Ellam, L. (1981) Electroconvulsive Treatment in Great Britain, 1980. A Report to the Royal College of Psychiatrists. London: Gaskell (Royal College of Psychiatrists).Google Scholar
Roberts, J. M. (1959) Prognostic factors in the electroshock treatment of depressive states. I—Clinical features from history and examination. Journal of Mental Science, 105, 693–702.Google Scholar
Strecker, E. A., Appel, K. E., Eyman, E. V. et al. (1931) The prognosis in manic-depressive psychosis. Association for Research in Nervous and Mental Disease, (Royal Society of Medicine), 11, 471–537.Google Scholar
West, E. (1981) Electric convulsion therapy in depression: a double-blind controlled trial. British Medical Journal, 282, 355–7.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms: an Instruction Manual for the PSE and Catego Systems. Cambridge: Cambridge University Press.Google Scholar
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