RESUMO
OBJECTIVE: Maintenance electroconvulsive therapy (M-ECT) is considered an effective relapse prevention strategy in severe mood and psychotic disorders. How long M-ECT should be continued, and what the outcome is after its discontinuation has not been adequately studied. In our tertiary psychiatric hospital, M-ECT treatments were suspended at the start of the COVID-19 pandemic. We aimed to determine the 6-month relapse rate and time to relapse after abrupt discontinuation of M-ECT and to assess the impact of patient and treatment characteristics on the risk of relapse. METHODS: Eighty-one patients whose M-ECT was discontinued abruptly were followed up prospectively for 6 months, or until relapse (i.e., hospital admission, restart of ECT, change of pharmacotherapy, or suicide (attempt)). We used multivariable Cox proportional hazards models to assess the impact of patient and treatment characteristics on the risk of relapse. RESULTS: Thirty-six patients (44.44%) relapsed within 6 months following abrupt discontinuation of M-ECT. A greater number of previous acute ECT courses, a diagnosis of psychotic disorder (compared with major depressive disorder or bipolar disorder), and a shorter interval between M-ECT treatments at the time of discontinuation were significantly associated with increased risk of relapse. CONCLUSION: Almost half of the patients relapsed, similar to the relapse rate after a successful acute course of ECT. Patients with a shorter interval between M-ECT treatments at the time of discontinuation seem to be at increased risk, as well as patients with a diagnosis of psychotic disorder, compared to patients with mood disorders.
Assuntos
COVID-19 , Transtorno Depressivo Maior , Eletroconvulsoterapia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Humanos , Pandemias , Recidiva , SARS-CoV-2 , Resultado do TratamentoAssuntos
Infecções por Coronavirus , Eletroconvulsoterapia , Controle de Infecções , Transtornos Mentais , Inovação Organizacional , Pandemias , Pneumonia Viral , Idoso , Betacoronavirus , COVID-19 , Gestão de Mudança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Eletroconvulsoterapia/métodos , Eletroconvulsoterapia/normas , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Avaliação das Necessidades , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Utilização de Procedimentos e Técnicas/normas , Utilização de Procedimentos e Técnicas/tendências , Medição de Risco , SARS-CoV-2 , Prevenção Secundária/métodosRESUMO
We describe a patient with new-onset temporal lobe epilepsy during prolonged maintenance electroconvulsive therapy. We suggest a possible causal relationship with maintenance electroconvulsive therapy through electrical kindling of the temporal lobe.
