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Improvement of postpartum depression and psychosis after electroconvulsive therapy: A population-based study with a matched comparison group

Artikel i vetenskaplig tidskrift
Författare S. Rundgren
O. Brus
U. Bave
Mikael Landén
J. Lundberg
P. Nordanskog
A. Nordenskjold
Publicerad i Journal of Affective Disorders
Volym 235
Sidor 258-264
ISSN 0165-0327
Publiceringsår 2018
Publicerad vid Institutionen för neurovetenskap och fysiologi
Sidor 258-264
Språk en
Länkar dx.doi.org/10.1016/j.jad.2018.04.04...
Ämnesord Puerperal disorders, Postpartum depression, Postpartum psychosis, Electroconvulsive therapy, antidepressant clinical-trials, puerperal mental-illness, impressions, rating-scale, pharmacological-treatment, psychiatric-disorders, relative, sensitivity
Ämneskategorier Neurovetenskap

Sammanfattning

Introduction: Electroconvulsive therapy (ECT) is used to treat postpartum depression and psychosis based on clinical experience and small observational studies. Aims: The primary aim was to test the hypothesis that the response rate to ECT for depression and psychosis is higher during the postpartum period than outside this period. The secondary aim was to identify predictors of a response to ECT during the postpartum period. Materials and methods: Cases with postpartum depression and/or psychosis received ECT within 6 months of delivery. A matched comparison group with depression and/or psychosis (not within the postpartum period) was identified from the Swedish National Quality Register for ECT. The improvement 1 week after ECT was classified according to the Clinical Global Impressions Scale - Improvement scale (CGI-I) as responder (CGI-I score 1-2) or non-responder (CGI-I score 3-7). Results: 185 cases and 185 comparison group subjects were included (46% with psychosis in each groups). More cases (87.0%) than comparison group subjects (73.5%) responded to ECT (p = 0.001). Adjusted binary regression analysis revealed that more severe symptoms prior to treatment were the only statistically significant predictor of response. Conclusion: The response rate of those with postpartum depression and/or psychosis to ECT was high. The response rate of patients with psychosis or depression was higher during the postpartum period than outside it. This study supports the use of ECT for severe forms of postpartum depression and/or psychosis.

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