Monday, May 2, 2022

ECT During Hospitalization for Depression Reduces Risk of Suicide by Nearly Half

Treating patients hospitalized for depression with electroconvulsive therapy (ECT) appears to reduce their risk of suicide by nearly 50% for at least one year, according to a study in Lancet Psychiatry. These findings came from a detailed analysis of nearly 70,000 hospital records from patients seen in psychiatric inpatient units in Ontario, Canada.

“We also found that this reduction in risk of death by suicide led to a significant reduction in all-cause mortality and that electroconvulsive therapy did not increase the risk of non-suicide deaths,” wrote Tyler Kaster, Ph.D., of the University of Toronto and colleagues. “Taken together, these findings support the view that electroconvulsive therapy can be a lifesaving treatment in patients with severe depression.”

Kaster and colleagues used Canadian registries to examine the mortality outcomes of all adults aged 18 and older with a primary diagnosis of major depressive disorder or bipolar disorder who were discharged from a psychiatric bed in Ontario between April 1, 2007, and December 31, 2017. Individuals were included in the analysis multiple times if their hospitalizations occurred more than 12 months apart. The final sample included 67,327 hospital discharges, of which 4,982 received ECT.

A total of 450 people included in the analysis died by suicide within 12 months of discharge from the psychiatric hospital; this included the deaths of 27 people in the group who had ECT (5.84 per 1,000 person-years) and 423 in the group who had not had to ECT (7.26 per 1,000 person-years).

After adjusting for potential variables that might influence receipt of ECT (such as age and medical comorbidities), the researchers found that patients who had received ECT in the hospital had a 47% reduced risk of suicide death and a 25% reduced risk of any death over 12 months compared with those who did not receive ECT. With regards to absolute risk reduction, ECT was found to be about as effective at reducing death by suicide as lithium, Kaster and colleagues added.

“This study reinforces the importance of electroconvulsive therapy, particularly for people with severe depression,” they wrote.

To read more on this topic, see the Psychiatric News article “Patients With Refractory Bipolar Depression May Benefit From ECT.”

(Image: iStock/gorodenkoff)

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