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The efficacy of acute electroconvulsive therapy in atypical depression.

Publication ,  Journal Article
Husain, MM; McClintock, SM; Rush, AJ; Knapp, RG; Fink, M; Rummans, TA; Rasmussen, K; Claassen, C; Petrides, G; Biggs, MM; Mueller, M ...
Published in: J Clin Psychiatry
March 2008

OBJECTIVE: This study examined the characteristics and outcomes of patients with major depressive disorder (MDD), with or without atypical features, who were treated with acute bilateral electroconvulsive therapy (ECT). METHOD: Analyses were conducted with 489 patients who met DSM-IV criteria for MDD. Subjects were identified as typical or atypical on the basis of the Structured Clinical Interview for DSM-IV obtained at baseline prior to ECT. Depression symptom severity was measured by the 24-item Hamilton Rating Scale for Depression (HAM-D(24)) and the 30-item Inventory of Depressive Symptomatology-Self-Report (IDS-SR(30)). Remission was defined as at least a 60% decrease from baseline in HAM-D(24) score and a total score of 10 or below on the last 2 consecutive HAM-D(24) ratings. The randomized controlled trial was performed from 1997 to 2004. RESULTS: The typical (N = 453) and atypical (N = 36) groups differed in several sociodemographic and clinical variables including gender (p = .0071), age (p = .0005), treatment resistance (p = .0014), and age at first illness onset (p < .0001) and onset of current episode (p = .0008). Following an acute course of bilateral ECT, a considerable portion of both the typical (67.1%) and the atypical (80.6%) groups reached remission. The atypical group was 2.6 (95% CI = 1.1 to 6.2) times more likely to remit than the typical group after adjustment for age, psychosis, gender, clinical site, and depression severity based on the HAM-D(24). CONCLUSION: Acute ECT is an efficacious treatment for depressed patients with typical or atypical symptom features. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00000375.

Duke Scholars

Published In

J Clin Psychiatry

DOI

EISSN

1555-2101

Publication Date

March 2008

Volume

69

Issue

3

Start / End Page

406 / 411

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Observer Variation
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electroconvulsive Therapy
 

Citation

APA
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ICMJE
MLA
NLM
Husain, M. M., McClintock, S. M., Rush, A. J., Knapp, R. G., Fink, M., Rummans, T. A., … Kellner, C. H. (2008). The efficacy of acute electroconvulsive therapy in atypical depression. J Clin Psychiatry, 69(3), 406–411. https://doi.org/10.4088/jcp.v69n0310

Published In

J Clin Psychiatry

DOI

EISSN

1555-2101

Publication Date

March 2008

Volume

69

Issue

3

Start / End Page

406 / 411

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Observer Variation
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electroconvulsive Therapy