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Which residual symptoms predict relapse after successful electroconvulsive therapy for late-life depression?

Published online by Cambridge University Press:  01 September 2022

S. Lambrichts ,
K. Vansteelandt ,
M. Wagenmakers ,
M. Oudega ,
J. Obbels ,
A. Dols ,
F. Bouckaert  and
P. Sienaert
S. Lambrichts*
Affiliation:
KU Leuven, University Psychiatric Center Ku Leuven, Kortenberg, Belgium
K. Vansteelandt
Affiliation:
KU Leuven, University Psychiatric Center Ku Leuven, Kortenberg, Belgium
M. Wagenmakers
Affiliation:
Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
M. Oudega
Affiliation:
Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
J. Obbels
Affiliation:
KU Leuven, University Psychiatric Center Ku Leuven, Kortenberg, Belgium
A. Dols
Affiliation:
Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
F. Bouckaert
Affiliation:
KU Leuven, University Psychiatric Center Ku Leuven, Kortenberg, Belgium
P. Sienaert
Affiliation:
KU Leuven, University Psychiatric Center Ku Leuven, Kortenberg, Belgium
*
*Corresponding author.

Abstract

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Introduction

Introduction: Residual depressive symptoms are common after a successful acute treatment of late-life depression (LLD), and their presence predicts increased risk of relapse. While electroconvulsive therapy (ECT) is the most effective treatment for LLD, little is known about which particular symptoms remain and impact long-term outcome after a successful acute ECT course.

Objectives

Objectives: We aimed to assess the association between specific residual depressive symptoms after an effective acute ECT course for LLD and relapse at six-month follow-up.

Methods

Methods: In this prospective cohort study, including 110 patients aged 55 years and older with LLD, information about relapse was collected six months after the acute ECT course. Relapse was defined as a Montgomery-Åsberg Depression Rating Scale (MADRS) score >15, hospital admission or restart of ECT. We used multivariable stepwise logistic regression models including the scores on the 10 individual MADRS items at the end of the acute ECT course to predict relapse.

Results

Results: Of the 80 responders with available six-month follow-up data, 29 patients (36.25%) had suffered relapse. Higher scores on the MADRS items ‘reduced sleep’ (odds ratio (OR)=2.03, 95% confidence interval (CI)=1.11-3.69, p=0.0214) and ‘lassitude’ (OR=1.62, 95% CI=1.00-2.62, p=0.0497) at the end of the acute ECT course were significantly associated with increased risk of relapse at six-month follow-up.

Conclusions

Conclusions: Some residual depressive symptoms, including sleep disturbance and fatigue, may help better identify patients vulnerable to relapse following a successful acute ECT course for LLD. Future studies assessing interventions that target specific residual symptoms may further reduce post-ECT depressive relapse.

Disclosure

No significant relationships.

Keywords

Electroconvulsive therapyResidual symptomsRelapseLate-life depression
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S173 - S174
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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