WHO RESPONDS TO ELECTROCONVULSIVE-THERAPY - A COMPARISON OF EFFECTIVEAND INEFFECTIVE FORMS OF TREATMENT

Background. It has been reported that real ECT is more effective than simulated treatment among depressed patients with delusions and/or ret ardation, and that ECT is not effective among depressed patients who l ack these features, Method. In two randomised, double-blind studies, 1 43 patients with major depression were subtyped regarding psychosis, r etardation and agitation. In both studies, low dosage, right unilatera l ECT was ineffective compared with other forms of ECT. This report ex amined whether the depressive subtypes differed in clinical response t o the ineffective and effective forms of ECT. Results. The therapeutic advantage of effective forms of ECT was similar across the depression subtypes. Patients who lacked both psychosis and retardation showed t his pattern. Conclusions. The findings cast doubt on the utility of th ese depression subtypes in predicting ECT response. ECT is a viable tr eatment option for patients with major depression regardless of the pr esence or absence of psychosis. retardation and/or agitation.