Adherence to clinical practice guidelines for using electroconvulsive therapy in elderly depressive patients. Yrondi, A., Blanc, O., Anguill, L., Arbus, C., Boudieu, L., Patoz, M., Arnould, A., Charpeaud, T., Genty, J., Abidine, R., Redon, M., Rey, R., Aouizerate, B., Bennabi, D., El-Hage, W., Etain, B., Holtzmann, J., Leboyer, M., Molière, F., Richieri, R. M., Stéphan, F., Vaiva, G., Sauvaget, A., Poulet, E., Haffen, E., Courtet, P., Fossati, P., Llorca, P., & Samalin, L. BMC psychiatry, 24(1):487, jul, 2024. doi abstract bibtex OBJECTIVES: Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. METHODS: In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. RESULTS: We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. CONCLUSION: Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long.
@article{Yrondi2024,
abstract = {OBJECTIVES: Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. METHODS: In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. RESULTS: We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. CONCLUSION: Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long.},
author = {Yrondi, Antoine and Blanc, Olivier and Anguill, Loic and Arbus, Christophe and Boudieu, Ludivine and Patoz, Marie-Camille and Arnould, Adeline and Charpeaud, Thomas and Genty, Jean-Baptiste and Abidine, Racan and Redon, Maximilien and Rey, Romain and Aouizerate, Bruno and Bennabi, Djamila and El-Hage, Wissam and Etain, Bruno and Holtzmann, J{\'{e}}r{\^{o}}me and Leboyer, Marion and Moli{\`{e}}re, Fanny and Richieri, Raphaelle Marie and St{\'{e}}phan, Florian and Vaiva, Guillaume and Sauvaget, Anne and Poulet, Emmanuel and Haffen, Emmanuel and Courtet, Philippe and Fossati, Philippe and Llorca, Pierre-Michel and Samalin, Ludovic},
doi = {10.1186/s12888-024-05933-7},
issn = {1471-244X (Electronic)},
journal = {BMC psychiatry},
keywords = {Aged,Aged, 80 and over,Bipolar Disorder,Depressive Disorder, Major,Electroconvulsive Therapy,Female,Guideline Adherence,Humans,Male,Practice Guidelines as Topic,Retrospective Studies,methods,therapy},
language = {eng},
month = {jul},
number = {1},
pages = {487},
pmid = {38961386},
title = {{Adherence to clinical practice guidelines for using electroconvulsive therapy in elderly depressive patients.}},
volume = {24},
year = {2024}
}
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Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. METHODS: In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. RESULTS: We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. CONCLUSION: Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long.","author":[{"propositions":[],"lastnames":["Yrondi"],"firstnames":["Antoine"],"suffixes":[]},{"propositions":[],"lastnames":["Blanc"],"firstnames":["Olivier"],"suffixes":[]},{"propositions":[],"lastnames":["Anguill"],"firstnames":["Loic"],"suffixes":[]},{"propositions":[],"lastnames":["Arbus"],"firstnames":["Christophe"],"suffixes":[]},{"propositions":[],"lastnames":["Boudieu"],"firstnames":["Ludivine"],"suffixes":[]},{"propositions":[],"lastnames":["Patoz"],"firstnames":["Marie-Camille"],"suffixes":[]},{"propositions":[],"lastnames":["Arnould"],"firstnames":["Adeline"],"suffixes":[]},{"propositions":[],"lastnames":["Charpeaud"],"firstnames":["Thomas"],"suffixes":[]},{"propositions":[],"lastnames":["Genty"],"firstnames":["Jean-Baptiste"],"suffixes":[]},{"propositions":[],"lastnames":["Abidine"],"firstnames":["Racan"],"suffixes":[]},{"propositions":[],"lastnames":["Redon"],"firstnames":["Maximilien"],"suffixes":[]},{"propositions":[],"lastnames":["Rey"],"firstnames":["Romain"],"suffixes":[]},{"propositions":[],"lastnames":["Aouizerate"],"firstnames":["Bruno"],"suffixes":[]},{"propositions":[],"lastnames":["Bennabi"],"firstnames":["Djamila"],"suffixes":[]},{"propositions":[],"lastnames":["El-Hage"],"firstnames":["Wissam"],"suffixes":[]},{"propositions":[],"lastnames":["Etain"],"firstnames":["Bruno"],"suffixes":[]},{"propositions":[],"lastnames":["Holtzmann"],"firstnames":["Jérôme"],"suffixes":[]},{"propositions":[],"lastnames":["Leboyer"],"firstnames":["Marion"],"suffixes":[]},{"propositions":[],"lastnames":["Molière"],"firstnames":["Fanny"],"suffixes":[]},{"propositions":[],"lastnames":["Richieri"],"firstnames":["Raphaelle","Marie"],"suffixes":[]},{"propositions":[],"lastnames":["Stéphan"],"firstnames":["Florian"],"suffixes":[]},{"propositions":[],"lastnames":["Vaiva"],"firstnames":["Guillaume"],"suffixes":[]},{"propositions":[],"lastnames":["Sauvaget"],"firstnames":["Anne"],"suffixes":[]},{"propositions":[],"lastnames":["Poulet"],"firstnames":["Emmanuel"],"suffixes":[]},{"propositions":[],"lastnames":["Haffen"],"firstnames":["Emmanuel"],"suffixes":[]},{"propositions":[],"lastnames":["Courtet"],"firstnames":["Philippe"],"suffixes":[]},{"propositions":[],"lastnames":["Fossati"],"firstnames":["Philippe"],"suffixes":[]},{"propositions":[],"lastnames":["Llorca"],"firstnames":["Pierre-Michel"],"suffixes":[]},{"propositions":[],"lastnames":["Samalin"],"firstnames":["Ludovic"],"suffixes":[]}],"doi":"10.1186/s12888-024-05933-7","issn":"1471-244X (Electronic)","journal":"BMC psychiatry","keywords":"Aged,Aged, 80 and over,Bipolar Disorder,Depressive Disorder, Major,Electroconvulsive Therapy,Female,Guideline Adherence,Humans,Male,Practice Guidelines as Topic,Retrospective Studies,methods,therapy","language":"eng","month":"jul","number":"1","pages":"487","pmid":"38961386","title":"Adherence to clinical practice guidelines for using electroconvulsive therapy in elderly depressive patients.","volume":"24","year":"2024","bibtex":"@article{Yrondi2024,\nabstract = {OBJECTIVES: Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. METHODS: In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. RESULTS: We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. 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