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P-1376 - Speed of Response in Bitemporal and Bifrontal Ect: a Case Series

Published online by Cambridge University Press:  15 April 2020

M. Palma
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
B. Ferreira
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
N. Borja Santos
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
B. Trancas
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
J. Parente
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
J. Ramos
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
M.C. Monteiro
Affiliation:
Day Hospital, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal
C. Klut
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
J. Graca
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
S. Xavier
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
A. Neto
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
M. Martins
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
J. Ribeiro
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal
G. Cardoso
Affiliation:
Psychiatry, Hospital Prof. Dr. Fernando Fonseca, EPE, Amadora, Portugal

Abstract

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Introduction

There is robust evidence recommending electroconvulsive therapy (ECT) in treating severe acute affective disorders. The clinical use of bitemporal electrode placement is still favoured to unilateral placement with just a relative disadvantage in cognitive side effects. Recently, bifrontal placement has gained popularity but there is still limited evidence on its relative benefits.

Objective

Compare bitemporal and bifrontal ECT efficacy in patients with pharmacologically resistant affective disorders, based on the number of acute phase treatments required to reach symptomatic remission.

Method

Review of all patients' charts submitted to acute phase ECT, between June 2006 and June 2011. A total of 70 ECT treatment courses performed in a group of 67 patients met inclusion criteria. Thirty-eight of the total 70 courses received bitemporal ECT, and 32 received bifrontal ECT. A statistical analysis was performed. An attempt to use t-test was foiled due to breach of population variance homogeneity (p = 0,021). The non-parametric Mann-Whitney test was the alternative choice (M-W = 534;p = 0,377).

Results

Bitemporal and bifrontal groups matched for age and sex. Bitemporal patients received on average five ECT treatments, while the average of bifrontal treatments to remission was six, but this difference was not statistically significant (p > 0.05).

Conclusions

Our results showed that bitemporal and bifrontal placements are equally effective. According to the largest randomised controlled trial conducted on ECT in depressive illness (Kellner et al,2010), bitemporal placement led to a faster rate of improvement. Additional studies and larger samples are required to understand if bifrontal placement's efficacy and cognitive advantages justify its popularity.

Type
Abstract
Copyright
Copyright © European Psychiatric Association 2012
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