Ana Jelovac, Christopher Mohan, Emma Whooley, Anna Igoe, Cathal McCaffrey, Declan M McLoughlin
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引用次数: 0
Abstract
Objective: Childhood maltreatment is associated with less favourable treatment outcomes with pharmacotherapy and psychotherapy for depression. It is unknown whether this increased risk of treatment resistance in maltreated individuals extends to electroconvulsive therapy (ECT).
Methods: This retrospective cohort study included 501 consecutive adult referrals for an acute course of twice-weekly ECT for unipolar or bipolar depression at an academic inpatient centre in Ireland between 2016 and 2024. Retrospectively reported physical and sexual childhood maltreatment were assessed on hospital admission. Response was defined as a score of 1 or 2 and remission was defined as a score of 1 on the Clinical Global Impression - Improvement scale 1-3 days after final ECT session. Logistic regression analyses were used to examine the associations between childhood maltreatment and ECT nonresponse and nonremission, adjusting for covariates. Mediation analyses were conducted to explore the role of psychiatric comorbidities, persistent depressive symptoms lasting 2 years or more in the current episode, and baseline depression severity.
Results: Compared to the group with no childhood maltreatment, the childhood maltreatment group had similar odds of ECT nonresponse (adjusted odds ratio = 1.47, 95% CI = 0.85-2.53) but significantly elevated odds of ECT nonremission (adjusted odds ratio = 3.75, 95% CI = 1.80-7.81). In a mediation analysis, presence of persistent depressive symptoms mediated 7.4% of the total effect of childhood maltreatment on ECT nonremission.
Conclusion: Individuals with exposure to childhood maltreatment may be less likely to achieve full remission following a course of ECT.
期刊介绍:
Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers.
Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.