Abstract
Objective: To determine the relative efficacy of electroconvulsive therapy (ECT) in the treatment of bipolar (BP) and unipolar (UP) depressive illness and clarify its role in BP depression. Method: Patients referred for ECT with both UP and BP depressions. [classified by Structured Clinical Interview for DSM (SCID-I) criteria for history of mania] were included in a multi-site collaborative, double-masked, randomized controlled trial of three electrode placements - right unilateral, bifrontal or bitemporal - in a permutated block randomization scheme. Results: Of 220 patients, 170 patients (77.3%) were classified as UP and 50 (22.7%) as BP depression in the intent-to-treat sample. The remission and response rates and numbers of ECT for both groups were equivalent. Conclusion: Both UP and BP depressions remit with ECT. Polarity is not a factor in the response rate. In this sample ECT did not precipitate mania in depressed patients. Treatment algorithms for UP and BP depression warrant re-evaluation.
Original language | English (US) |
---|---|
Pages (from-to) | 431-436 |
Number of pages | 6 |
Journal | Acta Psychiatrica Scandinavica |
Volume | 121 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2010 |
Keywords
- Bipolar depression
- Electroconvulsive therapy
- Electrode placement
- Remission rates
- Unipolar depression
ASJC Scopus subject areas
- Psychiatry and Mental health