A retrospective analysis of stimulus characteristics, clinical profile and cognition of patients receiving maintenance electroconvulsive therapy

ABSTRACT

Background: Maintenance electroconvulsive therapy (M-ECT) has been in use for a long time, yet there is dearth of literature regarding stimulus characteristics and cognitive changes with M-ECT, particularly in the Indian context. To assess stimulus characteristics, clinical profile and cognitive changes in patients receiving maintenance electroconvulsive therapy. Methodology: Records of patients receiving M-ECT in one year were checked and their diagnosis, stimulus characteristics (duration of current, seizure duration, number of ECTs and total charge delivered) and serial MMSE scores (at baseline, after 1 month and final MMSE) were noted. Stimulus characteristics were correlated with sociodemographic details and cognitive changes. A comparison between psychotic and non- psychotic disorders was also made. Results: In a total of 50 patients on M-ECT, total charge delivered was found to be significantly higher in females (P=0.02) and seizure duration was longer in males (P=0.04). Stimulus characteristics between psychotic and non-psychotic disorder did not differ (P > 0.05). MMSE score showed improvement with M- ECT (P = 0.01) and this was most significant between baseline and final MMSE (P < 0.05). Cognitive change negatively correlated with number of ECT (r = - 0.29, P = 0.04). Final MMSE score correlated only with baseline MMSE score (r = 0.47, P < 0.01). Conclusion: Stimulus characteristics vary with gender, but not age and diagnosis. Cognition improves with M-ECT and depends upon number of ECT and pre-ECT cognition