Clinical Research
Evaluation of efficacy and safety about sub-threshold modified electroconvulsive therapy for depression
Li Wei, Ji Chengjun, Yang Kebing, Cai Haipeng, Wang Xin, Yu Yongjun, Tan Yunlong
Published 2020-02-05
Cite as Chin J Psychiatry, 2020, 53(1): 42-48. DOI: 10.3760/cma.j.issn.1006-7884.2020.01.008
Abstract
ObjectiveThis study was aimed to evaluate the short-term antidepressive effect and the cognitive decline of the acute modified electroconvulsive therapy (MECT) course with 20% and 40% sub-threshold electricity stimulus dose in patients suffered with major depressive disorder.
MethodsA total of 108 patients who met the DSM-Ⅳ criteria of depression were enrolled and, according to the RAND procedure in excel, were randomly assigned into 3 groups: 20% electricity group, 40% electricity group, and 80% electricity group (control), with 36 cases each accordingly. All patients were given one 8 times MECT with consecutively 5 times in the first week followed by intermittently 3 times in the second week (once every the other day). Depression symptoms (assessed by HAMD17) and the cognitive function (assessed by the Repeatable Battery for the Assessment of Neuropsychological Status, RBANS) were evaluated at baseline, 4 to 8 hours after the first treatment, 4 to 8 hours after the last treatment, the end of the week-4 and the week-8. The results were compared by repeated measurement analysis of variance and one-way analysis of variance (ANOVA).
Results(1) There were significant differences in HAMD17 (F=10.769, P<0.05) and RBANS (F= 6.961, P<0.05) among the three groups. (2) The time × electricity group interactions of HAMD17 (F=3.450, P<0.05) and RBANS (F=2.501, P<0.05) scoring were of statistical significance. (3) The scores of HAMD17 after the last treatment (F=3.673, P<0.05), at week-4 (F=4.570, P<0.05), and week-8 (F=4.122, P<0.05) presented with significant difference among the three groups. There was no significant difference between either group and the control (P>0.05). However, there was significant difference in HAMD17 between the 20% electricity group and the 40% electricity group (P<0.05). (4) After the last treatment of MECT, the scores of RBANS among all three groups were significantly different (F=7.890, P<0.05). And compared to the control (55.2±11.2), the cognitive level measured by RBANS scores was relatively preserved in 20% (65.2±12.2) and 40% (63.9±11.5) electricity groups(P<0.05). At week-8, the scores of RBANS (F=2.770, P>0.05) were not significantly different among the three groups.
ConclusionSubthreshold MECT with the stimulus dose at 40% electricity seems not much different in antidepressive efficacy from the standard electricity dose, and the adverse impact on the cognitive function is relatively less. The efficacy of the 20% electricity dose is poor though the cognitive decline is also minimal.
Key words:
Electroconvulsive therapy; Depressive disorder; Efficacy; Cognition
Contributor Information
Li Wei
Peking University Huilongguan Clinical Medical School, Physical Therapy Center of Beijing Huilongguan Hospital, Beijing 100096, China
Ji Chengjun
Peking University Huilongguan Clinical Medical School, Physical Therapy Center of Beijing Huilongguan Hospital, Beijing 100096, China
Yang Kebing
Peking University Huilongguan Clinical Medical School, Physical Therapy Center of Beijing Huilongguan Hospital, Beijing 100096, China
Cai Haipeng
Peking University Huilongguan Clinical Medical School, Physical Therapy Center of Beijing Huilongguan Hospital, Beijing 100096, China
Wang Xin
Peking University Huilongguan Clinical Medical School, Physical Therapy Center of Beijing Huilongguan Hospital, Beijing 100096, China
Yu Yongjun
Peking University Huilongguan Clinical Medical School, Physical Therapy Center of Beijing Huilongguan Hospital, Beijing 100096, China
Tan Yunlong
Peking University Huilongguan Clinical Medical School, Hospital Office of Beijing Huilongguan Hospital, Beijing 100096, China
