Adherence to clinical practice guidelines for using electroconvulsive therapy in elderly depressive patients
2024
Yrondi, Antoine | Blanc, Olivier | Anguill, Loic | Arbus, Christophe | Boudieu, Ludivine | Patoz, Marie-Camille | Arnould, Adeline | Charpeaud, Thomas | Genty, Jean-Baptiste | Abidine, Racan | Redon, Maximilien | Rey, Romain | Aouizerate, Bruno | Bennabi, Djamila | El-Hage, Wissam | Etain, Bruno | Holtzmann, Jérôme | Leboyer, Marion | Molière, Fanny | Richieri, Raphaelle Marie | Stéphan, Florian | Vaiva, Guillaume | Sauvaget, Anne | Poulet, Emmanuel | Haffen, Emmanuel | Courtet, Philippe | Fossati, Philippe | Llorca, Pierre-Michel | Samalin, Ludovic | Service Psychiatrie et psychologie médicale [CHU Toulouse] ; Pôle Psychiatrie [CHU Toulouse] ; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse) | Fondation FondaMental [Créteil] | Toulouse NeuroImaging Center (ToNIC) ; Université Toulouse III - Paul Sabatier (UT3) ; Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI) ; Université Toulouse - Jean Jaurès (UT2J) ; Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3) ; Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J) ; Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3) ; Université de Toulouse (UT) | Service Psychiatrie Adulte [CHU Clermont-Ferrand] ; CHU Gabriel Montpied [Clermont-Ferrand] ; CHU Clermont-Ferrand-CHU Clermont-Ferrand-Pôle Psychiatrie Enfant-Adulte [CHU Clermont-Ferrand] ; CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand] ; CHU Clermont-Ferrand | Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) | Centre hospitalier Charles Perrens [Bordeaux] | Nutrition et Neurobiologie intégrée (NutriNeuro) ; Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Laboratoire de recherches Intégratives en Neurosciences et psychologie Cognitive (LINC) ; Université de Franche-Comté (UFC) | Centre Hospitalier Régional Universitaire de Tours (CHRU Tours) | GHU AP-HP Nord - Université Paris Cité | Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC) ; Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM) | Hôpital de la Conception [CHU - APHM] (LA CONCEPTION) | CHRU Brest - Psychiatrie Adulte (CHU - Brest- Psychiatrie) ; Centre Hospitalier Régional Universitaire de Brest (CHRU Brest) | Lille Neurosciences & Cognition - U 1172 (LilNCog) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [CHU Lille] (CHRU Lille) | Nantes Université (Nantes Univ) | Hospices Civils de Lyon (HCL) | Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon | Centre d'Investigation Clinique de Besançon (Inserm CIC 1431) ; Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC) ; Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC) | CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) | Institut Pascal (IP) ; Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne) ; Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA) | Pôle Psychiatrie Enfant-Adulte [CHU Clermont-Ferrand] ; CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand] ; CHU Clermont-Ferrand
International audience
Show more [+] Less [-]English. Objectives Electroconvulsive therapy (ECT) is one of the most effective treatments in mood disorders, mainly in major depressive episode (MDE) in the context of either unipolar (MDD) or bipolar disorder (BD). However, ECT remains a neglected and underused treatment. Older people are at high risk patients for the development of adverse drug reactions. In this context, we sought to determine the duration of MDEs and the number of lines of treatment before the initiation of ECT in patients aged 65 years or over according to the presence or absence of first-line indications for using ECT from international guidelines. Methods In this multicenter, retrospective study including patients aged 65 years or over with MDEs in MDD or BD who have been treated with ECT for MDEs, data on the duration of MDEs and the number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. Results We identified 335 patients. The mean duration of MDEs before ECT was about 9 months. It was significantly shorter in BD than in MDD- about 7 and 10 months, respectively. The co-occurrence of chronic medical disease increased the duration before ECT in the MDD group. The presence of first-line indications for using ECT from guidelines did not reduce the duration of MDEs before ECT, except where there was a previous response to ECT. The first-line indications reduced the number of lines of treatment before starting ECT. Conclusion Even if ECT seems to be a key treatment in the elderly population due to its efficacity and safety for MDEs, the delay before this treatment is still too long.
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