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Multicenter Study
. 2005 May;162(5):977-82.
doi: 10.1176/appi.ajp.162.5.977.

Relief of expressed suicidal intent by ECT: a consortium for research in ECT study

Charles H Kellner  1 , Max Fink, Rebecca Knapp, Georgios Petrides, Mustafa Husain, Teresa Rummans, Martina Mueller, Hilary Bernstein, Keith Rasmussen, Kevin O'connor, Glenn Smith, A John Rush, Melanie Biggs, Shawn McClintock, Samuel Bailine, Chitra Malur
Affiliations
Multicenter Study

Relief of expressed suicidal intent by ECT: a consortium for research in ECT study

Charles H Kellner et al. Am J Psychiatry. 2005 May.

Abstract

Objective: This study assessed the incidence, severity, and course of expressed suicidal intent in depressed patients who were treated with ECT. The data are from the first phase of an ongoing, collaborative multicenter study, the overall aim of which was to compare continuation ECT with pharmacotherapy in the prevention of relapse after a successful course of ECT.

Method: Suicidal intent, as expressed by patients during an interview, was scored at baseline and before each ECT session with item 3 on the 24-item Hamilton Depression Rating Scale in 444 patients with unipolar depression.

Results: One hundred thirty-one patients (29.5%) reported suicidal thoughts and acts (score of 3 or 4) at baseline. Scores decreased to 0 after 1 week (three ECT sessions) in 38.2% of the patients, after 2 weeks (six ECT sessions) in 61.1%, and in 80.9% at the end of the course of treatment.

Conclusions: Expressed suicidal intent in depressed patients was rapidly relieved with ECT. Evidence-based treatment algorithms for major depressive mood disorders should include dichotomization according to suicide risk, as assessed by interview. For patients at risk, ECT should be considered earlier than at its conventional "last resort" position.

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