CLINICAL PREDICTION OF RATE OF RESPONSE OF ENDOGENOUS DEPRESSION TO ELECTROCONVULSIVE THERAPY

In depression, the identification of predictors of fast response is necessary to improve patient selection for ECT. In a double-blind, prospective study of 32 endogenously depressed patients treated with ECT, we attempted to identify the clinical characteristics of ECT responders which predicted fast (requiring ≤ 5 treatments to produce maximum recovery) and slow (requiring ≥ 6 treatments to produce maximum recovery) response to ECT. Of the 22 ECT responders in the study, 13 were fast and 9 were slow responders. We found that male sex, and greater age associated with lesser initial severity of depression were significantly associated with fast recovery. Surprisingly, factors suggested or expected to predict good outcome with ECT failed to predict fast outcome. Finally, the treatment variables of mean seizure duration and stimulus waveform were found to be unrelated to recovery rate. The findings are briefly discussed.