Sex-specifics of ECT outcome

M A J T Blanken; M L Oudega; A W Hoogendoorn; C S Sonnenberg; D Rhebergen; U M H Klumpers; L Van Diermen; T Birkenhager; D Schrijvers; R Redlich; U Dannlowski; W Heindel; M Coenjaerts; P Nordanskog; L Oltedal; U Kessler; L M Frid; A Takamiya; T Kishimoto; M B Jorgensen; A Jorgensen; T Bolwig; L Emsell; P Sienaert; F Bouckaert; C C Abbott; P Péran; C Arbus; A Yrondi; M Kiebs; A Philipsen; J A van Waarde; E Prinsen; M van Verseveld; G Van Wingen; F Ten Doesschate; J A Camprodon; M Kritzer; T Barbour; M Argyelan; N Cardoner; M Urretavizcaya; C Soriano-Mas; K L Narr; R T Espinoza; J Prudic; S Rowny; Ph van Eijndhoven; I Tendolkar; A Dols

doi:10.1016/j.jad.2022.12.144

Sex-specifics of ECT outcome

M A J T Blanken^*
, M L Oudega
, A W Hoogendoorn
, C S Sonnenberg
, D Rhebergen
, U M H Klumpers
, L Van Diermen
, T Birkenhager
, D Schrijvers
, R Redlich
, U Dannlowski
, W Heindel
, M Coenjaerts
, P Nordanskog
, L Oltedal
, U Kessler
, L M Frid
, A Takamiya
, T Kishimoto
, M B Jorgensen

A Jorgensen, T Bolwig, L Emsell, P Sienaert, F Bouckaert, C C Abbott, P Péran, C Arbus, A Yrondi, M Kiebs, A Philipsen, J A van Waarde, E Prinsen, M van Verseveld, G Van Wingen, F Ten Doesschate, J A Camprodon, M Kritzer, T Barbour, M Argyelan, N Cardoner, M Urretavizcaya, C Soriano-Mas, K L Narr, R T Espinoza, J Prudic, S Rowny, Ph van Eijndhoven, I Tendolkar, A Dols

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors.

METHODS: Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms).

RESULTS: Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X 2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X 2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women.

CONCLUSION: The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.

Original language	English
Pages (from-to)	243-248
Number of pages	6
Journal	Journal of Affective Disorders
Volume	326
DOIs	https://doi.org/10.1016/j.jad.2022.12.144
Publication status	Published - 1 Apr 2023

Keywords

ECT
Electroconvulsive therapy
Major depressive disorder
Phenotype
Predictor
Sex
Sex-specific

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10.1016/j.jad.2022.12.144

1-s2.0-S0165032722015075-mainFinal published version, 836 KBLicence: Taverne

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Blanken, M. A. J. T., Oudega, M. L., Hoogendoorn, A. W., Sonnenberg, C. S., Rhebergen, D., Klumpers, U. M. H., Van Diermen, L., Birkenhager, T., Schrijvers, D., Redlich, R., Dannlowski, U., Heindel, W., Coenjaerts, M., Nordanskog, P., Oltedal, L., Kessler, U., Frid, L. M., Takamiya, A., Kishimoto, T., ... Dols, A. (2023). Sex-specifics of ECT outcome. Journal of Affective Disorders, 326, 243-248. https://doi.org/10.1016/j.jad.2022.12.144

@article{0c051446a06440b19d0d1c1a332c3d2b,

title = "Sex-specifics of ECT outcome",

abstract = "OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors.METHODS: Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 \% women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms).RESULTS: Remission rates of ECT were independent of sex, 48.0 \% in women and 45.7 \% in men (X 2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X 2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women. CONCLUSION: The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.",

keywords = "ECT, Electroconvulsive therapy, Major depressive disorder, Phenotype, Predictor, Sex, Sex-specific",

author = "Blanken, \{M A J T\} and Oudega, \{M L\} and Hoogendoorn, \{A W\} and Sonnenberg, \{C S\} and D Rhebergen and Klumpers, \{U M H\} and \{Van Diermen\}, L and T Birkenhager and D Schrijvers and R Redlich and U Dannlowski and W Heindel and M Coenjaerts and P Nordanskog and L Oltedal and U Kessler and Frid, \{L M\} and A Takamiya and T Kishimoto and Jorgensen, \{M B\} and A Jorgensen and T Bolwig and L Emsell and P Sienaert and F Bouckaert and Abbott, \{C C\} and P P{\'e}ran and C Arbus and A Yrondi and M Kiebs and A Philipsen and \{van Waarde\}, \{J A\} and E Prinsen and \{van Verseveld\}, M and \{Van Wingen\}, G and \{Ten Doesschate\}, F and Camprodon, \{J A\} and M Kritzer and T Barbour and M Argyelan and N Cardoner and M Urretavizcaya and C Soriano-Mas and Narr, \{K L\} and Espinoza, \{R T\} and J Prudic and S Rowny and \{van Eijndhoven\}, Ph and I Tendolkar and A Dols",

note = "Funding Information: R.R. received funding from Innovative Medical Research [RE111722 to RR] and German Research Foundation (DFG, grant RE4458/1-1 to RR). U.D. received funding from German Research Foundation \#8 FOR2107 DA1151/5-1 and DA1151/5-2 to UD. L.O. received funding from Western Norway Regional Health Authority Grant Nos. 911986 and 912238. A.K. Aki is supported by the Japan Agency for Medical Research and Development (AMED) under Grant Number JP21dm0307102h0003. L.E. received the Research Foundation Flanders (FWO) grant G0C0319N, KU Leuven Research Fund C24/18/095 and the Sequoia Fund for Research on Ageing and Mental Health. P.P. received MH125126 and MH111826. M.K. received a lecture fee by Innomed Medizintechnik in 2017 \& 2018 GW received funding from the Brain Foundation of the Netherlands (Hersenstichting). There are no further conflicts of interest. Publisher Copyright: {\textcopyright} 2022",

year = "2023",

month = apr,

day = "1",

doi = "10.1016/j.jad.2022.12.144",

language = "English",

volume = "326",

pages = "243--248",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier",

}

Blanken, MAJT, Oudega, ML, Hoogendoorn, AW, Sonnenberg, CS, Rhebergen, D, Klumpers, UMH, Van Diermen, L, Birkenhager, T, Schrijvers, D, Redlich, R, Dannlowski, U, Heindel, W, Coenjaerts, M, Nordanskog, P, Oltedal, L, Kessler, U, Frid, LM, Takamiya, A, Kishimoto, T, Jorgensen, MB, Jorgensen, A, Bolwig, T, Emsell, L, Sienaert, P, Bouckaert, F, Abbott, CC, Péran, P, Arbus, C, Yrondi, A, Kiebs, M, Philipsen, A, van Waarde, JA, Prinsen, E, van Verseveld, M, Van Wingen, G, Ten Doesschate, F, Camprodon, JA, Kritzer, M, Barbour, T, Argyelan, M, Cardoner, N, Urretavizcaya, M, Soriano-Mas, C, Narr, KL, Espinoza, RT, Prudic, J, Rowny, S, van Eijndhoven, P, Tendolkar, I & Dols, A 2023, 'Sex-specifics of ECT outcome', Journal of Affective Disorders, vol. 326, pp. 243-248. https://doi.org/10.1016/j.jad.2022.12.144

TY - JOUR

T1 - Sex-specifics of ECT outcome

AU - Blanken, M A J T

AU - Oudega, M L

AU - Hoogendoorn, A W

AU - Sonnenberg, C S

AU - Rhebergen, D

AU - Klumpers, U M H

AU - Van Diermen, L

AU - Birkenhager, T

AU - Schrijvers, D

AU - Redlich, R

AU - Dannlowski, U

AU - Heindel, W

AU - Coenjaerts, M

AU - Nordanskog, P

AU - Oltedal, L

AU - Kessler, U

AU - Frid, L M

AU - Takamiya, A

AU - Kishimoto, T

AU - Jorgensen, M B

AU - Jorgensen, A

AU - Bolwig, T

AU - Emsell, L

AU - Sienaert, P

AU - Bouckaert, F

AU - Abbott, C C

AU - Péran, P

AU - Arbus, C

AU - Yrondi, A

AU - Kiebs, M

AU - Philipsen, A

AU - van Waarde, J A

AU - Prinsen, E

AU - van Verseveld, M

AU - Van Wingen, G

AU - Ten Doesschate, F

AU - Camprodon, J A

AU - Kritzer, M

AU - Barbour, T

AU - Argyelan, M

AU - Cardoner, N

AU - Urretavizcaya, M

AU - Soriano-Mas, C

AU - Narr, K L

AU - Espinoza, R T

AU - Prudic, J

AU - Rowny, S

AU - van Eijndhoven, Ph

AU - Tendolkar, I

AU - Dols, A

N1 - Funding Information: R.R. received funding from Innovative Medical Research [RE111722 to RR] and German Research Foundation (DFG, grant RE4458/1-1 to RR). U.D. received funding from German Research Foundation #8 FOR2107 DA1151/5-1 and DA1151/5-2 to UD. L.O. received funding from Western Norway Regional Health Authority Grant Nos. 911986 and 912238. A.K. Aki is supported by the Japan Agency for Medical Research and Development (AMED) under Grant Number JP21dm0307102h0003. L.E. received the Research Foundation Flanders (FWO) grant G0C0319N, KU Leuven Research Fund C24/18/095 and the Sequoia Fund for Research on Ageing and Mental Health. P.P. received MH125126 and MH111826. M.K. received a lecture fee by Innomed Medizintechnik in 2017 & 2018 GW received funding from the Brain Foundation of the Netherlands (Hersenstichting). There are no further conflicts of interest. Publisher Copyright: © 2022

PY - 2023/4/1

Y1 - 2023/4/1

N2 - OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors.METHODS: Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms).RESULTS: Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X 2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X 2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women. CONCLUSION: The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.

AB - OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors.METHODS: Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms).RESULTS: Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X 2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X 2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women. CONCLUSION: The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.

KW - ECT

KW - Electroconvulsive therapy

KW - Major depressive disorder

KW - Phenotype

KW - Predictor

KW - Sex

KW - Sex-specific

UR - https://www.scopus.com/pages/publications/85147573003

U2 - 10.1016/j.jad.2022.12.144

DO - 10.1016/j.jad.2022.12.144

M3 - Article

C2 - 36632848

SN - 0165-0327

VL - 326

SP - 243

EP - 248

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Sex-specifics of ECT outcome

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Keywords

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