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Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features.

2016Journal article Open access
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dc.contributor.authorPalma, M
dc.contributor.authorFerreira, B
dc.contributor.authorBorja-Santos, N
dc.contributor.authorTrancas, B
dc.contributor.authorMonteiro, C
dc.contributor.authorCardoso, G
dc.date.accessioned2016-03-28T13:00:44Z
dc.date.available2016-03-28T13:00:44Z
dc.date.issued2016
dc.description.abstractBACKGROUND: The aim of this study was to investigate the effectiveness of electroconvulsive therapy (ECT) in medication-nonresponsive patients with mixed mania and bipolar depression. METHOD: Forty-one patients with mixed mania (DSM-IV diagnosis of bipolar I disorder, most recent episode mixed) and 23 patients with bipolar depression (DSM-IV diagnosis of bipolar I disorder, most recent episode depressed) consecutively assigned to ECT treatment were included in this study. Subjects were evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS), the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impressions-Severity of Illness scale (CGI-S). Assessments were carried out the day before starting ECT, 48 hours after completion of the third session (T1), and a week after the last session of ECT (T2). RESULTS: Both groups received an equal number of ECT sessions (mean +/- SD = 7.2 +/- 1.7 vs. 7.3 +/- 1.6). In both groups, within-group comparisons showed that there was a significant reduction in CGI-S score (mixed mania, p <.0001 at T1 and T2; bipolar depression, p < .01 at T1, p < .0001 at T2), MADRS total score (both groups, p < .0001 at T1 and T2), BPRS total score (mixed mania, p < .0001 at T1 and T2; bipolar depression, p < .001 at T1, p < .0001 at T2), and BPRS activation factor score (mixed mania, p < .0001 at T1 and T2; bipolar depression, NS at T1, p < .01 at T2). Between-group comparisons revealed that patients with mixed mania showed significantly greater decrease in MADRS score (p < .001) and a greater proportion of responders (CGI-S) than patients with bipolar depression at endpoint (56% [N = 23] vs. 26% [N = 6], p = .02). Patients with mixed mania showed a greater reduction in suicidality, as measured by MADRS score, than patients with bipolar depression (p < .02). CONCLUSION: In our study, ECT was associated with a substantial reduction in symptomatology, in both patients with mixed mania and those with bipolar depression. However, the mixed mania group exhibited a more rapid and marked response as well as a greater reduction in suicidal ideation. Response to ECT was not influenced by the presence of delusions.pt_PT
dc.identifier.citationDepress Res Treat. 2016;2016:8306071pt_PT
dc.identifier.doi10.1155/2016/8306071pt_PT
dc.identifier.issn2090-133X
dc.identifier.urihttp://hdl.handle.net/10400.10/1588
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherHindawi Pubpt_PT
dc.relation.publisherversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736372/pt_PT
dc.subjectElectroconvulsive therapypt_PT
dc.subjectBipolar disorderpt_PT
dc.subjectTerapêutica electroconvulsivapt_PT
dc.subjectPerturbação bipolarpt_PT
dc.titleEfficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features.pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceNew Yorkpt_PT
oaire.citation.titleDepression research and treatmentpt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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