Patients who receive continuation and/or maintenance electroconvulsive therapy (ECT) treatment after their acute ECT treatment are at lower risk of hospital readmission compared with those who receive acute treatment alone, according to a study in JAMA Psychiatry. The study also found that less than 8% of patients with schizophrenia, schizoaffective disorder, or depression who receive acute ECT receive continuation or maintenance ECT.
Anders Jørgensen, M.D., Ph.D., of Psychiatric Center Copenhagen, and colleagues examined data from 19,994 patients in the Danish Patient Registry who initiated treatment with ECT from 2003 to 2022. They defined ECT treatment as:
- Acute: Three or more treatments with less than seven days between adjacent treatments
- Continuation: Three or more treatments with at least seven days and less than 90 days between adjacent treatments after an acute ECT series within a 180-day time frame
- Maintenance: Ongoing ECT treatments with intervals of at least seven days and less than 90 days between adjacent treatments on day 181 and beyond
Among the 19,994 patients, 7.7% received continuation or maintenance ECT at any time point (5.1% continuation ECT only and 2.6% maintenance ECT). Patients with schizophrenia or schizoaffective disorder were more likely to receive continuation or maintenance ECT than patients with other disorders.
Patients who received continuation or maintenance ECT had a 32% lower risk of hospitalization within six months and a 38% lower risk of hospitalization in the second six months after finishing acute ECT than those who received acute ECT only. Continuation or maintenance ECT did not appear to reduce the risk of suicidal ideation, however.
“The results uniformly point to the clinical advantages of [continuation or maintenance] ECT, as measured by the risk of readmission, and indicate that this treatment option may be underused,” the researchers wrote. “In terms of costs of hospitalization and ECT, [continuation or maintenance] ECT was cost-effective when comparing expenses before vs after the acute ECT series.”
For related information, see the Psychiatric Services article “Barriers to the Implementation of Electroconvulsive Therapy (ECT): Results From a Nationwide Survey of ECT Practitioners.”
(Image: Getty Images/iStock/onurdongel)
Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.