Sex-specifics of ECT outcome

M. A. J. T. Blanken, M. L. Oudega, A. W. Hoogendoorn, C. S. Sonnenberg, D. Rhebergen, U. M. H. Klumpers, L. van Diermen, T. Birkenhager, D. Schrijvers, R. Redlich, U. Dannlowski, W. Heindel, M. Coenjaerts, P. Nordanskog, L. Oltedal, U. Kessler, L. M. Frid, A. Takamiya, T. Kishimoto, M. B. JorgensenA. Jorgensen, T. Bolwig, L. Emsell, P. Sienaert, F. Bouckaert, C. C. Abbott, P. Péran, C. Arbus, A. Yrondi, M. Kiebs, A. Philipsen, J. A. van Waarde, E. Prinsen, M. van Verseveld, G. van Wingen, F. ten Doesschate, J. A. Camprodon, M. Kritzer, T. Barbour, M. Argyelan, N. Cardoner, M. Urretavizcaya, C. Soriano-Mas, K. L. Narr, R. T. Espinoza, J. Prudic, S. Rowny, Ph. van Eijndhoven, I. Tendolkar, A. Dols

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)

Abstract

Objective: Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors. Methods: Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms). Results: Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women. Conclusion: The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.
Original languageEnglish
Pages (from-to)243-248
Number of pages6
JournalJournal of affective disorders
Volume326
Early online date9 Jan 2023
DOIs
Publication statusPublished - 1 Apr 2023

Keywords

  • ECT
  • Electroconvulsive therapy
  • Major depressive disorder
  • Phenotype
  • Predictor
  • Sex
  • Sex-specific

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