Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study

Chiyo Shibasaki,1 Minoru Takebayashi,1,2 Yasutaka Fujita,1 Shigeto Yamawaki3 1Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization (NHO) Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan; 2Department of Psychiatry, NHO Kure Me...

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Autores principales: Shibasaki C, Takebayashi M, Fujita Y, Yamawaki S
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Publicado: Dove Medical Press 2015
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spelling oai:doaj.org-article:ad80739569fd45189ba2e1eecdd3c5812021-12-02T02:12:03ZFactors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study1178-2021https://doaj.org/article/ad80739569fd45189ba2e1eecdd3c5812015-01-01T00:00:00Zhttp://www.dovepress.com/factors-associated-with-the-risk-of-relapse-in-schizophrenic-patients--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Chiyo Shibasaki,1 Minoru Takebayashi,1,2 Yasutaka Fujita,1 Shigeto Yamawaki3 1Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization (NHO) Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan; 2Department of Psychiatry, NHO Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan; 3Department of Psychiatry and Neurosciences, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan Purpose: Electroconvulsive therapy (ECT) is an effective treatment for depression and schizophrenia. However, there is a high rate of relapse after an initial response to ECT, even with antidepressant or antipsychotic maintenance therapy. This study was carried out to examine the factors that influence the risk of relapse in schizophrenic patients after a response to ECT.Patients and methods: We retrospectively reviewed the records of 43 patients with schizophrenia who received and responded to an acute ECT course. We analyzed the associated clinical variables and relapse after response to the acute ECT. Relapse was defined as a Clinical Global Impressions Improvement score ≥6 or a psychiatric rehospitalization.Results: All patients were treated with neuroleptic medication after the acute ECT course. The relapse-free rate of all 43 patients at 1 year was 57.3%, and the median relapse-free period was 21.5 months. Multivariate analysis showed that the number of ECT sessions was associated with a significant increase in the risk of relapse (hazard ratio: 1.159; P=0.033). Patients who were treated with adjunctive mood stabilizers as maintenance pharmacotherapy after the response to the acute ECT course were at a lower risk of relapse than were those treated without mood stabilizers (hazard ratio: 0.257; P=0.047).Conclusion: Our study on the recurrence of schizophrenia after a response to an acute ECT course suggests that the number of ECT sessions might be related to the risk of relapse and that adjunctive mood stabilizers might be effective in preventing relapse. Keywords: electroconvulsive therapy, relapse, risk factors, schizophreniaShibasaki CTakebayashi MFujita YYamawaki SDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 67-73 (2015)
institution DOAJ
collection DOAJ
language EN
topic Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Shibasaki C
Takebayashi M
Fujita Y
Yamawaki S
Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
description Chiyo Shibasaki,1 Minoru Takebayashi,1,2 Yasutaka Fujita,1 Shigeto Yamawaki3 1Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization (NHO) Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan; 2Department of Psychiatry, NHO Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan; 3Department of Psychiatry and Neurosciences, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan Purpose: Electroconvulsive therapy (ECT) is an effective treatment for depression and schizophrenia. However, there is a high rate of relapse after an initial response to ECT, even with antidepressant or antipsychotic maintenance therapy. This study was carried out to examine the factors that influence the risk of relapse in schizophrenic patients after a response to ECT.Patients and methods: We retrospectively reviewed the records of 43 patients with schizophrenia who received and responded to an acute ECT course. We analyzed the associated clinical variables and relapse after response to the acute ECT. Relapse was defined as a Clinical Global Impressions Improvement score ≥6 or a psychiatric rehospitalization.Results: All patients were treated with neuroleptic medication after the acute ECT course. The relapse-free rate of all 43 patients at 1 year was 57.3%, and the median relapse-free period was 21.5 months. Multivariate analysis showed that the number of ECT sessions was associated with a significant increase in the risk of relapse (hazard ratio: 1.159; P=0.033). Patients who were treated with adjunctive mood stabilizers as maintenance pharmacotherapy after the response to the acute ECT course were at a lower risk of relapse than were those treated without mood stabilizers (hazard ratio: 0.257; P=0.047).Conclusion: Our study on the recurrence of schizophrenia after a response to an acute ECT course suggests that the number of ECT sessions might be related to the risk of relapse and that adjunctive mood stabilizers might be effective in preventing relapse. Keywords: electroconvulsive therapy, relapse, risk factors, schizophrenia
format article
author Shibasaki C
Takebayashi M
Fujita Y
Yamawaki S
author_facet Shibasaki C
Takebayashi M
Fujita Y
Yamawaki S
author_sort Shibasaki C
title Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
title_short Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
title_full Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
title_fullStr Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
title_full_unstemmed Factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
title_sort factors associated with the risk of relapse in schizophrenic patients after a response to electroconvulsive therapy: a retrospective study
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/ad80739569fd45189ba2e1eecdd3c581
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