Drs. Parvin and Swartz asserted that the low remission and high relapse rates we documented
in a study of electroconvulsive (ECT) in major depression in community settings were
due to patient selection factors. Specifically, they speculated that in community
settings a substantial proportion of patients treated with ECT have the atypical subtype
of depression, while melancholic and catatonic subtypes are under-represented. They
also claimed that atypical depression does not respond to ECT, while melancholia and
catatonia are predictive of positive outcome. They further speculated that excluding
patients with a pre-ECT baseline Mini Mental State Examination (MMSE) score below
15 increases the representation of atypical depression. Finally, they claimed that
we did not prove that the low rates of response and remission to ECT were due to premature
ECT termination. The findings in this study contradict each of these assertions.
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References
- The Practice of ECT. Second Edition. American Psychiatric Press, Washington, DC2001
- 21CFR, Part 882, Neurological devices.Federal Register 55. 1990; 172 (September 5): 36578-36590
- Melancholia and response to ECT [letter].Am J Psychiatry. 1995; 152: 1242-1243
- The treatment validity of DSM-III melancholic subtyping.Psychiatry Res. 1985; 16: 37-43
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© 2004 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
