Depression Remission and Response Rates and Anxiety Response as a Predictor of Depression Response in a Community Electroconvulsive Therapy Clinic.

Objective

To assess depression response and remission rates with electroconvulsive therapy (ECT) in a community clinic and to identify factors predicting success in treatment.

Methods

Thirty-five patients were identified by a retrospective chart review with a diagnosis of major depressive disorder or depressive disorder not otherwise specified (according to the DSM-IV-TR) who were treated with an acute series of ECT at a community ECT clinic from March 1, 2014, to March 9, 2015. Logistic regression examined associations between clinical variables and depression response (defined as ≥50% reduction in score on the Patient Health Questionnaire-9 [PHQ-9]) and remission (final PHQ-9 score <5) rates and anxiety response rates (based on the Generalized Anxiety Disorder 7 item).

Results

Depression response and remission rates were 54.3% and 31.4%, respectively. This was a highly treatment-resistant sample, with an average of 5.3 antidepressant trials prior to initiating ECT. Improvement in anxiety symptoms was associated with depression response (odds ratio: 1.41, 95% CI, 1.11-1.78). Additionally, patients with initial severe anxiety scores were less likely than other patients to exhibit a response in depression (P=.027).

Conclusion

Almost half of this sample of patients with treatment-resistant depression did not respond to ECT in this community-based clinic, highlighting the challenges of treating this condition. Comorbid anxiety symptoms may reduce the likelihood of depression response, as patients with severe anxiety were less likely to respond. Prim Care Companion CNS Disord 2025;27(4):25m03939. Author affiliations are listed at the end of this article.