Work

Descriptive analysis of the Application of Electroconvulsive Therapy in patients with acute psychiatric pathology admitted to a Psychiatric Hospitalization Unit

Year: 2025

Type: article

Abstract: Introduction Electroconvulsive therapy (ECT) is a recognized treatment for various psychiatric conditions (Bernardo et al., 2018). However, there is a lack of recent studies describing the clinical characteristics of patients undergoing ECT (Peltzman et al., 2020). Objectives To provide an updated evaluation of the clinical characteristics, treatment parameters, and outcomes of patients receiving ECT at Clinica Universidad de Navarra (CUN), focusing on its effectiveness and evolution over recent years. Methods This cross-sectional descriptive study examines patients who underwent electroconvulsive therapy (ECT) at CUN’s Psychiatric Hospitalization Unit from January 2019 to August 2023. It focuses on those who received bifrontotemporal ECT, with stimulation power quantified using the DGx program on the Thymatron® machine. Collected data include age, sex, prior psychotropic medication use, ECT indication, comorbidities, Stimulus potency (%DGx), seizure duration (seconds on the electroencephalogram), and anesthetic induction type. Hamilton Anxiety and Depression Scales were recorded before and after treatment when clinically indicated. Results ECT was administered in 80 cases, constituting 8.62% of admitted patients, with 33.75% being male. Among these, 33% had psychiatric comorbidities, most commonly being pathological personality traits (16%) and generalized anxiety disorder (5.3%) (Image 1). Non-psychiatric comorbidities included endocrine-metabolic conditions 49% and cardiac conditions 34% (Image 2.) Pre-ECT, the most common psychotropic medications included benzodiazepines (87.5%), atypical antipsychotics (76.5%), and dual antidepressants (47.5%). Propofol was used for initial anesthetic induction in 86.25% of cases, with 30.43% requiring a switch to thiopental due to the reduced efficacy. The average number of ECT sessions per patient was 8.9 (range: 3-13), with a mean seizure duration of 30.5 seconds. The primary indications for ECT were depressive disorders (85%) and psychotic disorders (11%) (Image 3). Before ECT, the average Hamilton Depression Scale score was 25.3, decreasing to 5.3 post-treatment. Similarly, the Hamilton Anxiety Scale score average was 23.72 before ECT and 4.6 after. Image 1: Image 2: Image 3: Conclusions Our sample revealed that the primary indications for ECT were affective and psychotic disorders, with a predominant impact on adult women. This supports its role as a key intervention for treatment-resistant conditions, a finding consistent with existing literature (Leiknes et al., 2012). These preliminary results represent an initial evaluation in a broader study aimed at exploring additional aspects of clinical response and comparing ECT with other treatment modalities. Disclosure of Interest None Declared

Source: European Psychiatry

DOI: 10.1192/j.eurpsy.2025.2120