Maintenance Electroconvulsive Therapy in Severe Bipolar... : The Journal of ECT (original) (raw)

Original Studies

A Retrospective Chart Review

Santos Pina, Laura MD; Bouckaert, Filip MD; Obbels, Jasmien; Wampers, Martien PhD; Simons, Wim MD; Wyckaert, Sabien MD; Sienaert, Pascal MD, PhD

From the *University Psychiatric Center KU Leuven, Leuven; †Department of Psychiatry, Antwerp University Hospital, Antwerp; ‡Department of Old-Age Psychiatry, §ECT Department, and ∥Mood Disorders Programme, University Psychiatric Center KU Leuven, Leuven; and ¶Psychiatric Hospital Sint-Annendael, Diest, Belgium.

Received for publication March 2, 2015; accepted April 30, 2015.

Reprints: Pascal Sienaert, MD, PhD, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium (e-mail: [email protected]).

Pascal Sienaert has received honoraria for lectures by MECTA. The other authors have no conflicts of interest or financial disclosures to report.

Abstract

Objective

The aim of this study was to evaluate the effectiveness of continuation and maintenance electroconvulsive therapy (C/M-ECT) in patients with bipolar or schizoaffective disorder.

Methods

We reviewed the charts of all patients diagnosed with a bipolar or schizoaffective disorder treated with C/M-ECT from August 2009 until December 2013. We gathered demographic data and treatment variables (electrode placement, stimulus dose, and concomitant use of medication; number of C/M-ECT sessions; and number of new ECT courses). Primary outcome measure was the number of hospitalization days during C/M-ECT as compared with an equal period before starting the index course.

Results

Twenty women (64.5%) and 11 men (35.5%) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar disorder (n = 22, 71%) or schizoaffective disorder (n = 9, 29%) received C/M-ECT. The mean (SD) age was 51.23 (14.86; range, 28–74) years. Before the start of the index ECT, patients had a mean of 290 hospitalization days (248.4 days, full hospitalization; 41.6 days, partial hospitalization), whereas during C/M-ECT, they had a mean of 214.7 hospitalization days (85.4 days, full hospitalization; 129.3 days, partial hospitalization). The number of readmissions before ECT was 2.13, whereas during C/M-ECT, it decreased to 1.48. Only the decrease in number of full hospitalization days was significant. Most patients (n = 23, 74.19%) needed an acute course of ECT during M-ECT.

Conclusions

Maintenance ECT seems to significantly reduce the number of full hospitalization days in patients with severe bipolar or schizoaffective disorder.