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Examining the clinical effectiveness of continuation and maintenance electroconvulsive therapy in schizophrenia
George, Rachna Krishnan, Vijay Talbot, Daniel Elhindi, James Mayur, Prashanth Harris, Anthony
George, Rachna
Krishnan, Vijay
Talbot, Daniel
Elhindi, James
Mayur, Prashanth
Harris, Anthony
Abstract
Objective
There are few studies that examine the effectiveness of Continuation/Maintenance Electroconvulsive Therapy (C/M-ECT) in schizophrenia, despite the documented effectiveness of acute ECT treatment. We aimed to investigate the clinical effectiveness of C/M-ECT for in-patients with Schizophrenia in a naturalistic setting. We examined the medical records of 46 in-patients who were diagnosed with Schizophrenia and had received C/M-ECT belonging to non-acute extended care service in a public psychiatry hospital in Sydney, Australia. The focus of analysis was on 138 treatment cycles (71 acute only cycles and 67 acute-continuation/maintenance cycles) across 45 subjects. A linear mixed effects model was used to describe the change in clinical global impression-severity (CGI-S) over time 4 time points viz., pre-post acute and pre-post continuation/maintenance ECT.
Results
Acute-only cycles and acute-continuation/maintenance cycles had identical pre- (M = 5, C.I. = 4–6), post-cycle CGI-S scores, and identical CGI-S difference scores (M = 0, C.I. = −1 – 1). Broadly in each continuation/maintenance cycle, we observed an initial sharp decrease in CGI-S scores followed by a logarithmic increase in scores over time, with satisfactory CGI-S score maintenance observed for approximately 6 months. Bitemporal ECT influenced CGI-S across maintenance ECT (p < 0.05) indicating smaller declines in CGI-S scores over time.
Conclusion
In schizophrenia, C/M ECT preserves effects on illness severity for at least upto 6 months following an acute course of ECT. Bitemporal ECT vis a vis other electrode positions differentiated clinical severity over time.
Keywords
schizophrenia, ECT, continuation ECT, maintenance ECT, naturalistic, bitemporal ECT
Date
2024
Type
Journal article
Journal
Asian Journal of Psychiatry
Book
Volume
92
Issue
Page Range
1-4
Article Number
Article 103895
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled
Notes
© 2024 Elsevier B.V. All rights reserved.