Effectiveness of electroconvulsive therapy on treatment-resistant depressive disorder: A population-based mirror-image study
Journal
Journal of Psychiatric Research
Journal Volume
121
Pages
101-107
Date Issued
2020
Author(s)
Abstract
The clinical effects of electroconvulsive therapy (ECT) in treatment-resistant depressive disorders need to be systemically examined in representative samples. This study aimed to examine whether ECT reduced re-hospitalization within one year after discharge. The authors used the Psychiatric Inpatients Medical Claim Dataset, a subset of a total population health claims database from Taiwan, to include 784 inpatients with treatment-resistant depressive disorders screened for ECT during hospitalization between 2001 and 2011. The same number of comparison subjects was selected by frequency matching on the demographic and clinical characteristics. Using a mirror-image comparison design, we compared group differences in re-hospitalization rate, number of hospital days, number of emergency department visits, and direct medical costs during the 1-year pre- and post-ECT periods. The modifying effects of patients’ characteristics on these outcomes were also explored. The results showed that ECT was associated with a significant decrease in the rate of hospitalizations and emergency department visits over the 1-year follow-up period. However, there were no significant difference in the reduced rate of hospitalizations between ECT and comparison group. Demographic and clinical characteristic had no modifying effect on the odds of psychiatric hospitalization. In conclusions, ECT could reduce the rate of hospitalization and number of emergency department visits in patients with treatment-resistant depressive disorders. However, the study results might be biased by the inherent deficits of mirror-image design. ? 2019
SDGs
Other Subjects
adult; aged; Article; clinical effectiveness; electroconvulsive therapy; emergency ward; female; follow up; health care cost; hospital readmission; hospitalization; human; major clinical study; male; population research; priority journal; treatment outcome; treatment resistant depression; comparative study; economics; electroconvulsive therapy; methodology; middle aged; Taiwan; treatment resistant depression; young adult; Adult; Aged; Depressive Disorder, Treatment-Resistant; Electroconvulsive Therapy; Female; Follow-Up Studies; Hospitalization; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Patient Readmission; Research Design; Taiwan; Young Adult
Publisher
Elsevier Ltd
Type
journal article