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Prediction of ECT Response: Validation of a Refined Sign-Based (CORE) System for Defining Melancholia

Published online by Cambridge University Press:  02 January 2018

Ian Hickie ,
Catherine Mason ,
Gordon Parker  and
Henry Brodaty
Ian Hickie*
Affiliation:
Academic Department of Psychiatry, The St George Hospital and Community Service, 7 Chapel St, Kogarah, 2217, and School of Psychiatry, University of New South Wales
Gordon Parker
Affiliation:
School of Psychiatry, University of New South Wales
Henry Brodaty
Affiliation:
Academic Department of Psychogeriatrics, University of New South Wales, Sydney
*
Associate Professor I. Hickie, Academic Department of Psychiatry, The St George Hospital and Community Service, 7 Chapel Street, Kogarah, New South Wales 2217, Australia
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Abstract

Background

The clinical validity of melancholia has been argued on the basis of its capacity to predict response to electroconvulsive therapy (ECT). We have argued that a sign-based (CORE) rating system of psychomotor disturbance can identify patients with melancholia. Therefore, the clinical validity of the CORE system was tested here in terms of its capacity to predict response to ECT.

Method

The response of 81 patients with primary affective disorders to an individualised course of ECT was investigated. CORE scores and other clinical predictors were evaluated in terms of their capacity to predict effect size changes in symptoms and disability.

Results

CORE scores predicted ECT response, as did the presence of psychotic features. The combination of marked psychomotor change (high CORE scores) and psychotic features predicted the best response to ECT.

Conclusion

This study supports the clinical validity of the CORE system for diagnosing melancholia.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 1 , July 1996 , pp. 68 - 74
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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