Impacts of the Duration and Number of Electroconvulsive Therapy (ECT) Sessions on Clinical Course and Treatment of the Patients with Major Depressive Disorder

Abstract

Objective: The aim of this study is to investigate impacts of the duration and number of electroconvulsive therapies on clinical course and treatment of the patients with major depressive disorder. Method: This study included 50 patients, who applied to psychiatry clinic of Erenkoy Mental Health and Neurology Training & Research Hospital for inpatient treatment due to the diagnosis of major depressive disorder and who displayed electroconvulsive therapy (ECT) indication. The patients were subjected to Hamilton Rating Scale for Depression (HRSD) for pre-ECT period and for 1st and 2nd weeks of ECT, and to Clinical Global Impression Scale (CGIS) for the period following application of ECT. Total durations of ECT convulsions were assessed. Furthermore, a data form identifying sociodemographic properties, previous ECT history and current ECT indications of the patients was filled in. Results: The patients were classified by ECT indications as Resistance to Treatment (+): Group I, Suicide Ideation (+): Group II; and no statistically significant difference was observed among groups in terms of sociodemographic properties, total number of ECT sessions, duration of ECT, and HRSD scores for pre-ECT period and for 1st and 2nd weeks of ECT (p>0.05). CGIS scores checked after each ECT statistically significantly decreased (p<0.001), while the number of patients with decreased CGIS scores obtained after application of ECT increased. 45.5% of the patients with ECT history and 82.9% of the patients without any ECT history were determined to have got into remission (p<0.05). Conclusion: According to the data evaluated in this study, we can safely argue that if the patients with major depressive disorder displaying resistance to treatment, refusal to eat and drink and suicide ideation were allowed to have sufficient number of ECT sessions with sufficient duration, ECT would work as an effective treatment method affecting depression and clinical improvement levels. The fact that the patients with positive ECT history have lower rate of remission as compared to the patients without ECT history made the authors consider the possibility that the disease may have crossed into chronic stage or former ECT sessions may have decreased the susceptibility to treatment.