People undergoing voluntary and involuntary ECT treatment have similar outcomes

June 28, 2018

People who have involuntary electroconvulsive therapy (ECT) for depression have similar outcomes to those who have voluntary treatment, according to a ground-breaking new study conducted by researchers from Trinity College Dublin's Department of Psychiatry.

The findings, which have just been published in the July issue of the journal Brain Stimulation, are based on the largest study of its kind internationally and one of very few studies to report on people requiring involuntary treatment, who are rarely able to take part in clinical research. The results provide reassurance for people who have had involuntary ECT, their families and healthcare providers, according to Professor of Psychiatry Declan McLoughlin from Trinity's Department of Psychiatry and Trinity Institute of Neuroscience.

The study found that people who have involuntary ECT were more severely unwell before treatment than those having voluntary ECT and were more likely to have psychotic symptoms such as hallucinations and delusions, and have more physical deterioration as a result of severe self-neglect. However, in both groups, outcomes at the end of ECT were similar, with the large majority of people rated "very much improved" or "much improved".

Depression is one of the leading causes of disability worldwide. People who suffer from severe depression may lose the capacity to make decisions and require treatment under mental health law in order to recover. ECT is the most effective acute treatment for severe depression and is sometimes administered as an involuntary treatment. In Ireland, approximately fifty people require involuntary ECT each year.

The research team, led by Professor McLoughlin, studied the records of five years of involuntary ECT treatment at St Patrick's Mental Health Services, Dublin, Ireland. The team reported on 48 involuntary ECT courses and compared these with 96 courses of voluntary ECT administered to people of the same age and sex at the same time.

The results shed light on a group about which little is known and provide a stronger evidence base for patients receiving involuntary ECT under the provisions of mental health legislation, according to Professor McLoughlin.

"People who require involuntary ECT are among the most severely unwell in our mental health services. Yet, because they generally lack decision-making capacity and cannot take part in research, we do not know for sure if we can apply research advances to persons having involuntary ECT. Our knowledge of how best to use ECT to help someone recover from severe depression is based on research samples comprised entirely of people choosing to have voluntary ECT."

"Our results are reassuring for people who have had involuntary ECT and their families. It's also a relief to mental health professionals to know that the research results on which we base treatment decisions for voluntary treatment can now be used with greater confidence to also guide treatment for people having involuntary ECT."

He cautioned, however, that "although ECT is a safe and highly effective evidence-based treatment, ongoing research is essential to understand who will benefit most from the treatment, and how to help people with depression stay well after recovery".
-end-
The paper, "Involuntary and voluntary electroconvulsive therapy: a case-control study", Brain Stimulation (2018), Martha Finnegan, Stephanie O'Connor, and Declan M. McLoughlin, can be viewed at: https://www.sciencedirect.com/science/article/pii/S1935861X18301037?via%3Dihub

Professor McLoughlin's Depression Neurobiology Research Group in Trinity's School of Medicine is funded by the Health Research Board and Medical Charities Research Group. More information about the work of the research group is available at: https://www.tcd.ie/medicine/psychiatry/research/projects/depression-neurobiology.php

Trinity College Dublin

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.