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Rehospitalization Risk, Treatment Costs Lower With Continued/Maintenance ECT
Continuing electroconvulsive therapy (ECT) after an acute ECT series is linked with lower rehospitalization risk compared with not continuing ECT, according to study results published in JAMA Psychiatry.
The finding stemmed from a cohort study of all patients in the Danish National Patient Registry who began ECT treatment between 2003 and 2022. Researchers were interested in real-world outcomes of patients treated with continuation and maintenance ECT (c/mECT) after an acute ECT series.
The study included a total 19,944 patients treated with ECT. Among them, 5.1% received continuation ECT (defined as more than 3 treatments, with 7 and 90 days between them, within 180 days after an acute ECT series) and 2.6% received maintenance ECT (defined as more than 3 treatments, with 7 and 90 days between them, over a time frame lasting more than 180 days after acute ECT).
Schizophrenia and schizoaffective disorder were more common, and unipolar depression was less common, among patients who received c/mECT compared with patients who received acute ECT alone, researchers reported.
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Compared with acute ECT, patients who received c/mECT had a lower hospitalization rate at 6 months. According to the study, c/mECT was associated with a 0.68 adjusted hazard ratio and a 0.51 incidence rate ratio for 6-month hospitalization among patients. The risk of suicidal behavior did not differ between patients treated with c/mECT and those treated with acute ECT alone, the study found.
Meanwhile, a cost-effectiveness analysis showed a substantial reduction in total treatment costs with c/mECT compared with before acute ECT ended.
“In a nationwide and naturalistic setting, c/mECT after acute ECT was infrequently used but associated with a lower risk of readmission than acute ECT alone,” wrote first author Anders Jørgensen, MD, PhD, of the University of Copenhagen, Copenhagen, Denmark, and study coauthors. “The totality of the evidence indicates that c/mECT should be considered more often to prevent relapse after successful acute ECT in patients whose condition does not respond sufficiently to other interventions.”
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