P0314 - Efficicay of maintenance ECT- a naturalistic retrospective study

Abstract

Background and Aim:

It has been suggested that mECT reduce relapse rates in chronic/recurrent depression. We aimed to study its efficacy in this group.

Method:

A retrospective analysis of 19 patients who received mECT following a successful course of acute ECT. We compared admission rates and bed occupancy during the mECT period with periods of 2-4 years before and after mECT. Information was gathered from case-notes and hospital records. This group was then compared with a similarly matched group, who received a successful index aECT followed by other non-ECT maintenance therapies to compare for secular trends.

Results:

19 patients - average age 70.6 (44-88) received mECT (ave. 37 (12-89) applications, mean interval-2.5 weeks). Admission rate fell from 1.02 admission/year to 0.316 (p < 0.001) and acute in-patient stay from 15.24 weeks/year pre-mECT to 7.05 during mECT, p = 0.055 . This was maintained once mECT was stopped. This compared well with comparison group who went on to receive other mentainance therapy (for the same period to control for secular changes), where both admission rates and bed occupancy went up. The change in duration of hospital stay between the two groups were statistically very significant (p<0.001) in favour of the mECT group.

Conclusion:

The findings suggest that mECT may have a role in reducing the rate and duration of hospital stay of patients with major depressive disorder. The main weaknesses are the small sample size. This may translate in to socio-economic benefits both for the patients and the health services.