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Who Responds to Electroconvulsive Therapy?

A Comparison of Effective and Ineffective Forms of Treatment

Published online by Cambridge University Press:  02 January 2018

Christina Sobin ,
Joan Prudic ,
D. P. Devanand ,
Mitchell S. Nobler  and
Harold A. Sackeim
Christina Sobin
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Department of Biological Psychiatry, New York State Psychiatric Institute, New York, US
Joan Prudic
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Department of Biological Psychiatry, New York State Psychiatric Institute, New York, US
D. P. Devanand
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Department of Biological Psychiatry, New York State Psychiatric Institute, New York, US
Mitchell S. Nobler
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Department of Biological Psychiatry, New York State Psychiatric Institute, New York, US
Harold A. Sackeim*
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Department of Biological Psychiatry, New York State Psychiatric Institute, New York, US
*
Dr H. A. Sackeim, Department of Biological Psychiatry, New York State Psychiatric Institute, 722 West 168th Street, New York, NY 10032, US
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Abstract

Background

It has been reported that real ECT is more effective than simulated treatment among depressed patients with delusions and/or retardation, and that ECT is not effective among depressed patients who lack these features.

Method

In two randomised, double-blind studies, 143 patients with major depression were subtyped regarding psychosis, retardation and agitation. In both studies, low dosage, right unilateral ECT was ineffective compared with other forms of ECT. This report examined whether the depressive subtypes differed in clinical response to the ineffective and effective forms of ECT.

Results

The therapeutic advantage of effective forms of ECT was similar across the depression subtypes. Patients who lacked both psychosis and retardation showed this pattern.

Conclusions

The findings cast doubt on the utility of these depression subtypes in predicting ECT response. ECT is a viable treatment option for patients with major depression regardless of the presence or absence of psychosis, retardation and/or agitation.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 3 , September 1996 , pp. 322 - 328
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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