Treatment outcomes and cognitive function following electroconvulsive therapy in patients with severe depression

Table 1 Baseline characteristics of the participants

Variable	ECT group (n = 102)	Non-ECT group (n = 102)	P value
Age (yr)	46.3 ± 11.2	45.8 ± 10.9	0.69
Sex (female/male)	58/44	60/42	0.81
Duration of MDD (mo)	24.6 ±12.8	25.4 ± 13.1	0.07
Type of MDD (unipolar/bipolar)	82/20	84/18	0.76
HDRS score	28.4 ± 3.6	28.2 ± 3.7	0.72
WHOQOL-BREF score	42.6 ± 8.9	43.1 ± 9.2	0.66
MoCA score	24.8 ± 3.2	25.1 ± 3.4	0.54
BDNF level (ng/mL)	18.6 ± 5.4	18.9 ± 5.7	0.62
IL-6 level (pg/mL)	3.4 ± 1.2	3.5 ± 1.3	0.58
Cortisol level (ng/mL)	12.7 ± 4.1	12.9 ± 4.3	0.71

Values are shown as average ± deviation or count. ECT: Electroconvulsive treatment; MDD: Major depressive condition; HDRS: Hamilton depression evaluation scale; WHOQOL-BREF: World Health Organization Quality of Life-BREF Assessment; MoCA: Montreal cognitive evaluation; BDNF: Brain-derived neurotrophic factor; IL-6: Interleukin-6.

Table 2 Changes in hamilton depression evaluation scale score and secondary outcomes from baseline to 12 wk, n (%)

Outcome	ECT group (n = 102)	Non-ECT group (n = 102)	P value
HDRS score	-19.6 ± 6.4 (-69)	-14.2 ± 7.2 (-50)	< 0.001
WHOQOL-BREF score	+15.4 ± 8.7 (+37)	+9.2 ± 7.9 (+21)	< 0.001
MoCA score	+2.6 ± 1.4 (+10)	+1.0 ± 1.2 (+4)	< 0.001
BDNF level (ng/mL)	-12.8 ± 4.6 (-69)	-18.6 ± 5.8 (-98)	< 0.001
IL-6 level (pg/mL)	+2.2 ± 0.9 (+65)	+3.4 ± 1.2 (+97)	< 0.001
Cortisol level (ng/mL)	-0.2 ± 3.8 (-2)	-0.1 ± 4.1 (-1)	0.92

Values are depicted as average ± deviation with percentage alteration in brackets. ECT: Electroconvulsive treatment; HDRS: Hamilton depression evaluation scale; WHOQOL-BREF: World Health Organization Quality of Life-BREF Assessment; MoCA: Montreal cognitive evaluation; BDNF: Brain-derived neurotrophic factor; IL-6: Interleukin-6.

Table 3 Adverse events reported by the participants, n (%)

Adverse event	ECT group (n = 102)	Non-ECT group (n = 102)	P value
Headache	32 (31)	28 (27)	0.54
Nausea	24 (24)	22 (22)	0.76
Dizziness	18 (18)	16 (16)	0.72
Memory impairment	14 (14)	12 (12)	0.69
Insomnia	10 (10)	14 (14)	0.39
Weight gain	8 (8)	10 (10)	0.63
Sexual dysfunction	6 (6)	8 (8)	0.57
Agitation	4 (4)	6 (6)	0.51
Confusion	2 (2)	2 (2)	> 0.99
Seizure prolongation1	2 (2)	N/A2	N/A2

Data are presented as number and percentage.

¹Seizure prolongation was defined as a seizure duration > two min.

²Seizure prolongation was not applicable for the non-electroconvulsive therapy group. ECT: Electroconvulsive therapy; N/A: Not applicable.