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KMID : 0605720220280030098
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Journal of the Korean Society of Biological Therapies in Psychiatry
2022 Volume.28 No. 3 p.98 ~ p.108
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Clinical Factors Related to Change of Depression Severity in Major Depressive Disorder Through Index Electroconvulsive Therapy
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Yang Jae-Won
Kim Yang-Tae
Kim Hee-Cheol
Jung Sung-Won
Lee Ho-Jun
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Abstract
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Objectives：The aim of this study was to investigate the factors associated with changes in depression severity in index electroconvulsive therapy (ECT) for major depressive disorder.
Methods：A retrospective analysis was performed on 80 patients with major depressive disorder who received index ECT. The severity of depression was assessed using the Hamilton depression rating scale-17 (HDRS-17). Multiple linear regression analysis and logistic regression analysis were performed to identify the factors associated with the change of depression severity and the predictors of the 50% or greater reduction rate of HDRS-17.
Results：55 (68.8%) patients were HDRS-17 score change ≥50% group, and 25 (31.2%) patients were HDRS-17 score change <50% group. HDRS-17 score change ≥50% group had a shorter episode duration before ECT (11.91±8.63 vs 17.68±11.15 weeks, p=0.027) and more ECT sessions (8.60±2.91 vs 6.80±3.34 sessions, p=0.017). The higher baseline score of anxiety (B=0.937, β=0.374, p<0.001), depression (B=0.846, β=0,324, p=0.001), and somatic symptom (B=0.995, β=0.210, p=0.031) dimensions was associated with the change of HDRS-17 score from baseline. The longer episode duration until the start of ECT was associated with lower likelihood of HDRS-17 score change ≥50% (Wald χ2=7.74, OR=1.08, 95% CI: 1.02-1.14, p=0.005). The greater number of ECT sessions predicted the HDRS-17 score change ≥50% (Wald χ2=7.85, OR=0.75, 95% CI=0.62-0.92, p=0.005).
Conclusions：In higher baseline anxiety, depression, and somatic symptoms severity, implementing sufficient sessions of ECT in pharmacological treatment phase of relatively shorter duration of major depressive episode may help reduce HDRS-17 score.
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KEYWORD
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Electroconvulsive therapy, Major depressive disorder, Depression, Anxiety, Regression analysis
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