The Northwick Park Ect Trial: Predictors of Response to Real and Simulated Ect

The clinical characteristics of 70 patients included in the Northwick Park ECT trial of real against simulated ECT were analysed to identify predictors of response to the two treatments. The initial agitated/deluded/retarded substratification, the initial assessment of delusions by PSE, the individual items and factors derived from the Hamilton depression scale were all evaluated, together with six scales previously held to predict response to ECT and the individual items of these scales. The limited size of the sample does not allow firm conclusions, but the most significant and only consistent predictor of response to real ECT appeared to be the presence of delusions. The features of ‘endogenous depression’ did not in themselves appear to predict response to real ECT. The findings are discussed in relation to the viewpoint that delusional depression may be a specific entity which is relatively resistant to tricyclic antidepressants but responsive to electroconvulsive shock.