Electroconvulsive Therapy: A Scotland-Wide Naturalistic Study of 4826 Treatment Episodes

TY - JOUR

T1 - Electroconvulsive Therapy

T2 - A Scotland-Wide Naturalistic Study of 4826 Treatment Episodes

AU - Martin, Julie Langan

AU - Strawbridge, Rona J.

AU - Christmas, David

AU - Fleming, Michael

AU - Kelly, Stephen

AU - Varveris, Daphne

AU - Martin, Daniel

N1 - Copyright: © 2024 The Authors

PY - 2025/3

Y1 - 2025/3

N2 - Background: Electroconvulsive therapy (ECT) is an effective treatment option for several psychiatric disorders, including treatment-resistant depression, but there are concerns about potential adverse effects, particularly on cognition. This study describes ECT response and side effects in the Scottish ECT Audit Network.Methods: Data collected from 4826 treatment episodes includes pre-ECT and post-ECT illness severity scores (Clinical Global Impression-Severity [CGI-S] and Montgomery–Åsberg Depression Rating Scale [MADRS]), diagnosis, age, sex, consent status, treatment year, treatment frequency, dose, and reported side effects. Descriptive statistics were used to assess the response to ECT by diagnosis, and logistic regression was used to investigate which factors influenced ECT response and side-effect occurrence.Results: CGI-S scale scores were reduced after ECT in all diagnoses. For patients with depression or bipolar depression, MADRS scores were also reduced after ECT. The most common side effect was headaches (29%). Increased age and increased CGI-S scores were significantly associated (multiple-testing corrected p < .05) with better treatment response and more cognitive side effects.Conclusions: In a large observational outcome study of ECT, ECT appears to be effective (measured by reduction in CGI-S or MADRS scores) across a range of psychiatric diagnoses. Furthermore, increased age and increased illness severity scores at entry were the variables most significantly associated with treatment response and cognitive side effects.

AB - Background: Electroconvulsive therapy (ECT) is an effective treatment option for several psychiatric disorders, including treatment-resistant depression, but there are concerns about potential adverse effects, particularly on cognition. This study describes ECT response and side effects in the Scottish ECT Audit Network.Methods: Data collected from 4826 treatment episodes includes pre-ECT and post-ECT illness severity scores (Clinical Global Impression-Severity [CGI-S] and Montgomery–Åsberg Depression Rating Scale [MADRS]), diagnosis, age, sex, consent status, treatment year, treatment frequency, dose, and reported side effects. Descriptive statistics were used to assess the response to ECT by diagnosis, and logistic regression was used to investigate which factors influenced ECT response and side-effect occurrence.Results: CGI-S scale scores were reduced after ECT in all diagnoses. For patients with depression or bipolar depression, MADRS scores were also reduced after ECT. The most common side effect was headaches (29%). Increased age and increased CGI-S scores were significantly associated (multiple-testing corrected p < .05) with better treatment response and more cognitive side effects.Conclusions: In a large observational outcome study of ECT, ECT appears to be effective (measured by reduction in CGI-S or MADRS scores) across a range of psychiatric diagnoses. Furthermore, increased age and increased illness severity scores at entry were the variables most significantly associated with treatment response and cognitive side effects.

KW - Clinical Global Index-Severity Scale

KW - Depression

KW - Electroconvulsive therapy

KW - Montgomery–Åsberg Depression Rating Scale

KW - Response

KW - Side effects

UR - https://www.scopus.com/pages/publications/85215607494

U2 - 10.1016/j.bpsgos.2024.100434

DO - 10.1016/j.bpsgos.2024.100434

M3 - Article

C2 - 39926701

AN - SCOPUS:85215607494

SN - 2667-1743

VL - 5

JO - Biological Psychiatry Global Open Science

JF - Biological Psychiatry Global Open Science

IS - 2

M1 - 100434

ER -