The impact of treatment resistance on outcome and course of electroconvulsive therapy in major depressive disorder Article Swipe
J. J. E. Rovers
,
P. Vissers
,
Dore Loef
,
Jeroen A. van Waarde
,
Joey Verdijk
,
Birit F. P. Broekman
,
A. C. M. Vergouwen
,
Mardien L. Oudega
,
Eric van Exel
,
R. Coenen
,
Daphne Everaerd
,
Indira Tendolkar
,
Annemiek Dols
,
Philip van Eijndhoven
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1111/acps.13550
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1111/acps.13550
Introduction Major depressive disorder (MDD) is a common psychiatric disorder. Despite several treatment options, a subgroup of patients will not respond to the commonly used antidepressant treatments and thus express treatment resistance (TRD). TRD can be quantified with the Dutch Measure for Treatment Resistance in Depression (DM‐TRD). Electroconvulsive therapy (ECT) is an effective treatment for MDD, also in TRD. Yet, the position of ECT as “treatment‐of‐last‐resort” may decrease the likelihood of beneficial outcome. Our aim was to investigate the association between treatment resistance and outcome and course of ECT. Methods We performed a retrospective, multicenter cohort study with 440 patients of which data was retrieved from patient records as collected in the Dutch ECT Cohort database. Linear and logistic regression models were used to explore the association between level of treatment resistance and outcome of ECT. Median split was used to explore the differences between high and low level of TRD and course of treatment. Results A higher DM‐TRD score was associated with significantly smaller reduction of depression symptoms ( R 2 = 0.160; β = −2.968; p < 0.001) and lower chance of response (OR = 0.821 [95 CI: 0.760–0.888]; β = −0.197; p < 0.001). Low level TRD patients underwent fewer ECT sessions (mean 13 ± 6 SD vs. 16 ± 7 SD; p < 0.001) and fewer switches from right unilateral tot bifrontotemporal electrode placement (29% vs. 40%; p = 0.032). Conclusion Reserving ECT as “treatment‐of‐last‐resort” in the treatment algorithm for MDD seems questionable, because in our study lower level of treatment resistance predicted more beneficial ECT‐outcome. Moreover, providing ECT in less treatment resistant patients showed fewer needed ECT‐sessions and less switches to BL electrode placement, which may decrease the risk for cognitive side‐effects.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1111/acps.13550
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/acps.13550
- OA Status
- hybrid
- Cited By
- 9
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4361269881
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4361269881Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1111/acps.13550Digital Object Identifier
- Title
-
The impact of treatment resistance on outcome and course of electroconvulsive therapy in major depressive disorderWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-03-30Full publication date if available
- Authors
-
J. J. E. Rovers, P. Vissers, Dore Loef, Jeroen A. van Waarde, Joey Verdijk, Birit F. P. Broekman, A. C. M. Vergouwen, Mardien L. Oudega, Eric van Exel, R. Coenen, Daphne Everaerd, Indira Tendolkar, Annemiek Dols, Philip van EijndhovenList of authors in order
- Landing page
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https://doi.org/10.1111/acps.13550Publisher landing page
- PDF URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/acps.13550Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/acps.13550Direct OA link when available
- Concepts
-
Electroconvulsive therapy, Treatment-resistant depression, Major depressive disorder, Depression (economics), Antidepressant, Cohort, Internal medicine, Medicine, Logistic regression, Psychiatry, Psychology, Schizophrenia (object-oriented programming), Cognition, Macroeconomics, Hippocampus, EconomicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
9Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 3, 2024: 4, 2023: 2Per-year citation counts (last 5 years)
- References (count)
-
32Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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