Clinical and sociodemographic characteristics associated with relapse following electroconvulsive therapy for bipolar disorder.

IF 5 2区医学 Q1 CLINICAL NEUROLOGY Bipolar Disorders Pub Date : 2024-12-01 Epub Date: 2024-08-12 DOI:10.1111/bdi.13485

Rasmus Bengt Thomsen, Estela Salagre, Christopher Rohde, Søren Dinesen Østergaard

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Abstract

Objectives: Electroconvulsive therapy (ECT) is an effective treatment for bipolar disorder, but relapse following a successful ECT series is common. We aimed to identify clinical and sociodemographic characteristics associated with the risk of relapse following ECT in bipolar disorder.

Methods: Using data from nationwide Danish registers, we identified all patients receiving their first ECT series with an indication diagnosis of bipolar disorder between 2006 and 2018. We then followed these patients for relapse, defined as either psychiatric admission or a new ECT series, for 6 months following ECT. Associations between clinical and sociodemographic characteristics and relapse were examined via multivariable Cox proportional-hazards regression, yielding adjusted hazard rate ratios (aHRR).

Results: Of the 1473 patients receiving ECT for bipolar disorder (62% females, mean age = 53 years), 34% met the relapse criterion. The following characteristics were associated with an elevated risk of relapse; age <40 (aHRR = 1.54, 95% CI = 1.05-2.26); being a pensioner (aHRR = 1.73, 95% CI = 1.29-2.32), indication diagnosis for ECT being psychotic mania (aHRR = 1.63, 95% CI = 1.16-2.28), psychotic bipolar depression (aHRR = 1.37, 95% CI = 1.06-1.80), mixed episode (aHRR = 1.51, 95% CI = 1.13-2.02), or other bipolar episodes (aHRR = 1.68, 95% CI = 1.28-2.21); and treatment with antipsychotics prior to the course of ECT (aHRR = 1.32, 95% CI = 1.04-1.67).

Conclusion: Patients with bipolar disorder face a particularly high risk of relapse following ECT if they present with the following characteristics when initiating ECT: age <40, being a pensioner, having received treatment with an antipsychotic before initiating ECT, or having psychotic bipolar depression, psychotic mania, mixed episodes, or other bipolar episodes as the indication for ECT. These findings may guide relapse monitoring following ECT in bipolar disorder.

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与双相情感障碍电休克疗法后复发相关的临床和社会人口特征。

目的：电休克疗法（ECT）是治疗躁郁症的一种有效方法，但在一系列成功的ECT治疗后复发的情况很常见。我们旨在确定与双相情感障碍电休克疗法后复发风险相关的临床和社会人口特征：我们利用丹麦全国性登记册中的数据，确定了 2006 年至 2018 年间接受首次电痉挛疗法治疗的所有患者，其适应症诊断为双相情感障碍。然后，我们对这些患者的复发情况进行了跟踪调查，复发的定义是在接受电痉挛疗法后的 6 个月内入院治疗或再次接受电痉挛疗法。我们通过多变量考克斯比例危害回归检验了临床和社会人口学特征与复发之间的关系，得出了调整后的危害率比（aHRR）：在接受电痉挛疗法治疗双相情感障碍的 1473 名患者中（62% 为女性，平均年龄为 53 岁），34% 符合复发标准。以下特征与复发风险升高有关：年龄结论：双相情感障碍患者面临着复发的风险：如果双相情感障碍患者在开始接受电痉挛疗法时具有以下特征，那么他们在接受电痉挛疗法后复发的风险会特别高：年龄

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来源期刊

Bipolar Disorders 医学-精神病学

CiteScore

8.20

自引率

7.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.