The 5-year longitudinal diagnostic profile and health services utilization of patients treated with electroconvulsive therapy in Quebec: a population-based study
Purpose Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize...
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| Veröffentlicht in: | Social Psychiatry and Psychiatric Epidemiology 2023-04, Vol.58 (4), p.629-639 |
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| creator | Lafrenière, Simon Gholi-Zadeh-Kharrat, Fatemeh Sirois, Caroline Massamba, Victoria Rochette, Louis Brousseau-Paradis, Camille Patry, Simon Gagné, Christian Lemasson, Morgane Gariépy, Geneviève Mérette, Chantal Rahme, Elham Lesage, Alain |
| description | Purpose
Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize the longitudinal profile of psychopathology and services utilization of patients first treated with ECT.
Methods
We conducted a population-based comparative study using data from a national administrative database in Quebec. Patients who received a first ECT between 2002 and 2016 were compared to controls who were hospitalized in psychiatry but did not receive ECT. We performed descriptive analyses to compare psychiatric diagnoses, domains of psychopathology (internalizing, externalizing and thought/psychotic disorders), medical services and medication use in the 5 years prior to the ECT or hospitalization.
Results
5 080 ECT patients were compared with 179 594 controls. Depressive, anxiety, bipolar and psychotic disorders were more frequent in the ECT group. 96.2% of ECT patients had been diagnosed with depression and 53.8% with a primary psychotic disorder. In the ECT group, 1.0% had been diagnosed exclusively with depression and 47.0% had disorders from that belong to all three domains of psychopathology. Having both internalizing and thought/psychotic disorders was associated with an increased likelihood of receiving ECT vs having internalizing disorders alone (unadjusted OR = 2.93; 95% CI = 2.63, 3.26). All indicators of mental health services utilization showed higher use among ECT patients.
Conclusion
Our results provide robust evidence of complex longitudinal psychopathology and extensive services utilization among ECT patients. |
| doi_str_mv | 10.1007/s00127-022-02369-w |
| format | Article |
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Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize the longitudinal profile of psychopathology and services utilization of patients first treated with ECT.
Methods
We conducted a population-based comparative study using data from a national administrative database in Quebec. Patients who received a first ECT between 2002 and 2016 were compared to controls who were hospitalized in psychiatry but did not receive ECT. We performed descriptive analyses to compare psychiatric diagnoses, domains of psychopathology (internalizing, externalizing and thought/psychotic disorders), medical services and medication use in the 5 years prior to the ECT or hospitalization.
Results
5 080 ECT patients were compared with 179 594 controls. Depressive, anxiety, bipolar and psychotic disorders were more frequent in the ECT group. 96.2% of ECT patients had been diagnosed with depression and 53.8% with a primary psychotic disorder. In the ECT group, 1.0% had been diagnosed exclusively with depression and 47.0% had disorders from that belong to all three domains of psychopathology. Having both internalizing and thought/psychotic disorders was associated with an increased likelihood of receiving ECT vs having internalizing disorders alone (unadjusted OR = 2.93; 95% CI = 2.63, 3.26). All indicators of mental health services utilization showed higher use among ECT patients.
Conclusion
Our results provide robust evidence of complex longitudinal psychopathology and extensive services utilization among ECT patients.</description><identifier>ISSN: 0933-7954</identifier><identifier>EISSN: 1433-9285</identifier><identifier>DOI: 10.1007/s00127-022-02369-w</identifier><identifier>PMID: 36163429</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Bipolar Disorder - therapy ; Care and treatment ; Comparative studies ; Depression, Mental ; Disorders ; Domains ; Electroconvulsive Therapy ; Epidemiology ; Facilities and Services Utilization ; Health care industry ; Health services ; Health services utilization ; Humans ; Medical care ; Medicine ; Medicine & Public Health ; Mental depression ; Mental health ; Observational studies ; Original Paper ; Population-based studies ; Psychiatric services ; Psychiatry ; Psychology, Pathological ; Psychopathology ; Psychosis ; Psychotic Disorders - diagnosis ; Psychotic Disorders - epidemiology ; Psychotic Disorders - therapy ; Quebec - epidemiology ; Utilization</subject><ispartof>Social Psychiatry and Psychiatric Epidemiology, 2023-04, Vol.58 (4), p.629-639</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-82bf54f55336feeea4c74283709f6d550ef38ef2bd8f81fb5b6fe0dc19f5da8a3</citedby><cites>FETCH-LOGICAL-c442t-82bf54f55336feeea4c74283709f6d550ef38ef2bd8f81fb5b6fe0dc19f5da8a3</cites><orcidid>0000-0003-0704-4754</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00127-022-02369-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00127-022-02369-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36163429$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lafrenière, Simon</creatorcontrib><creatorcontrib>Gholi-Zadeh-Kharrat, Fatemeh</creatorcontrib><creatorcontrib>Sirois, Caroline</creatorcontrib><creatorcontrib>Massamba, Victoria</creatorcontrib><creatorcontrib>Rochette, Louis</creatorcontrib><creatorcontrib>Brousseau-Paradis, Camille</creatorcontrib><creatorcontrib>Patry, Simon</creatorcontrib><creatorcontrib>Gagné, Christian</creatorcontrib><creatorcontrib>Lemasson, Morgane</creatorcontrib><creatorcontrib>Gariépy, Geneviève</creatorcontrib><creatorcontrib>Mérette, Chantal</creatorcontrib><creatorcontrib>Rahme, Elham</creatorcontrib><creatorcontrib>Lesage, Alain</creatorcontrib><title>The 5-year longitudinal diagnostic profile and health services utilization of patients treated with electroconvulsive therapy in Quebec: a population-based study</title><title>Social Psychiatry and Psychiatric Epidemiology</title><addtitle>Soc Psychiatry Psychiatr Epidemiol</addtitle><addtitle>Soc Psychiatry Psychiatr Epidemiol</addtitle><description>Purpose
Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize the longitudinal profile of psychopathology and services utilization of patients first treated with ECT.
Methods
We conducted a population-based comparative study using data from a national administrative database in Quebec. Patients who received a first ECT between 2002 and 2016 were compared to controls who were hospitalized in psychiatry but did not receive ECT. We performed descriptive analyses to compare psychiatric diagnoses, domains of psychopathology (internalizing, externalizing and thought/psychotic disorders), medical services and medication use in the 5 years prior to the ECT or hospitalization.
Results
5 080 ECT patients were compared with 179 594 controls. Depressive, anxiety, bipolar and psychotic disorders were more frequent in the ECT group. 96.2% of ECT patients had been diagnosed with depression and 53.8% with a primary psychotic disorder. In the ECT group, 1.0% had been diagnosed exclusively with depression and 47.0% had disorders from that belong to all three domains of psychopathology. Having both internalizing and thought/psychotic disorders was associated with an increased likelihood of receiving ECT vs having internalizing disorders alone (unadjusted OR = 2.93; 95% CI = 2.63, 3.26). All indicators of mental health services utilization showed higher use among ECT patients.
Conclusion
Our results provide robust evidence of complex longitudinal psychopathology and extensive services utilization among ECT patients.</description><subject>Analysis</subject><subject>Bipolar Disorder - therapy</subject><subject>Care and treatment</subject><subject>Comparative studies</subject><subject>Depression, Mental</subject><subject>Disorders</subject><subject>Domains</subject><subject>Electroconvulsive Therapy</subject><subject>Epidemiology</subject><subject>Facilities and Services Utilization</subject><subject>Health care industry</subject><subject>Health services</subject><subject>Health services utilization</subject><subject>Humans</subject><subject>Medical care</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental depression</subject><subject>Mental health</subject><subject>Observational studies</subject><subject>Original Paper</subject><subject>Population-based studies</subject><subject>Psychiatric services</subject><subject>Psychiatry</subject><subject>Psychology, Pathological</subject><subject>Psychopathology</subject><subject>Psychosis</subject><subject>Psychotic Disorders - diagnosis</subject><subject>Psychotic Disorders - epidemiology</subject><subject>Psychotic Disorders - therapy</subject><subject>Quebec - epidemiology</subject><subject>Utilization</subject><issn>0933-7954</issn><issn>1433-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ktuKFDEQhoMo7rj6Al5IwBtves2pT94tiydYEGG9Dul0ZSZLJmmT9Ayzb-Obmp5ZXRSREFKQ7_-pKn6EXlJyQQlp3yZCKGsrwli5vOmr_SO0ooLzqmdd_RitSF_qtq_FGXqW0i0hhPctf4rOeEMbLli_Qj9uNoDr6gAqYhf82uZ5tF45PFq19iFlq_EUg7EOsPIj3oByeYMTxJ3VkPCcrbN3KtvgcTB4KhX4nHCOoDKMeG8LDQ50jkEHv5tdsjvAeQNRTQdsPf46wwD6HVZ4CtPsjlbVoFIRp9LM4Tl6YpRL8OL-PUffPry_ufpUXX_5-Pnq8rrSQrBcdWwwtTB1zXljAEAJ3QrW8Zb0phnrmoDhHRg2jJ3pqBnqoWBk1LQ39ag6xc_Rm5NvGff7DCnLrU0anFMewpwka2nXFHNCC_r6L_Q2zLFsbaF6zsTSxAO1Vg6k9SbkqPRiKi9bIYpPf_S6-AdVzghbWzYGy-r_FLCTQMeQUgQjp2i3Kh4kJXLJhTzlQpZcyGMu5L6IXt13PA9bGH9LfgWhAPwEpPLl1xAfRvqP7U8gi8Z-</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Lafrenière, Simon</creator><creator>Gholi-Zadeh-Kharrat, Fatemeh</creator><creator>Sirois, Caroline</creator><creator>Massamba, Victoria</creator><creator>Rochette, Louis</creator><creator>Brousseau-Paradis, Camille</creator><creator>Patry, Simon</creator><creator>Gagné, Christian</creator><creator>Lemasson, Morgane</creator><creator>Gariépy, Geneviève</creator><creator>Mérette, Chantal</creator><creator>Rahme, Elham</creator><creator>Lesage, Alain</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0704-4754</orcidid></search><sort><creationdate>20230401</creationdate><title>The 5-year longitudinal diagnostic profile and health services utilization of patients treated with electroconvulsive therapy in Quebec: a population-based study</title><author>Lafrenière, Simon ; Gholi-Zadeh-Kharrat, Fatemeh ; Sirois, Caroline ; Massamba, Victoria ; Rochette, Louis ; Brousseau-Paradis, Camille ; Patry, Simon ; Gagné, Christian ; Lemasson, Morgane ; Gariépy, Geneviève ; Mérette, Chantal ; Rahme, Elham ; Lesage, Alain</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-82bf54f55336feeea4c74283709f6d550ef38ef2bd8f81fb5b6fe0dc19f5da8a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analysis</topic><topic>Bipolar Disorder - therapy</topic><topic>Care and treatment</topic><topic>Comparative studies</topic><topic>Depression, Mental</topic><topic>Disorders</topic><topic>Domains</topic><topic>Electroconvulsive Therapy</topic><topic>Epidemiology</topic><topic>Facilities and Services Utilization</topic><topic>Health care industry</topic><topic>Health services</topic><topic>Health services utilization</topic><topic>Humans</topic><topic>Medical care</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental depression</topic><topic>Mental health</topic><topic>Observational studies</topic><topic>Original Paper</topic><topic>Population-based studies</topic><topic>Psychiatric services</topic><topic>Psychiatry</topic><topic>Psychology, Pathological</topic><topic>Psychopathology</topic><topic>Psychosis</topic><topic>Psychotic Disorders - diagnosis</topic><topic>Psychotic Disorders - epidemiology</topic><topic>Psychotic Disorders - therapy</topic><topic>Quebec - epidemiology</topic><topic>Utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lafrenière, Simon</creatorcontrib><creatorcontrib>Gholi-Zadeh-Kharrat, Fatemeh</creatorcontrib><creatorcontrib>Sirois, Caroline</creatorcontrib><creatorcontrib>Massamba, Victoria</creatorcontrib><creatorcontrib>Rochette, Louis</creatorcontrib><creatorcontrib>Brousseau-Paradis, Camille</creatorcontrib><creatorcontrib>Patry, Simon</creatorcontrib><creatorcontrib>Gagné, Christian</creatorcontrib><creatorcontrib>Lemasson, Morgane</creatorcontrib><creatorcontrib>Gariépy, Geneviève</creatorcontrib><creatorcontrib>Mérette, Chantal</creatorcontrib><creatorcontrib>Rahme, Elham</creatorcontrib><creatorcontrib>Lesage, Alain</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Social Psychiatry and Psychiatric Epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lafrenière, Simon</au><au>Gholi-Zadeh-Kharrat, Fatemeh</au><au>Sirois, Caroline</au><au>Massamba, Victoria</au><au>Rochette, Louis</au><au>Brousseau-Paradis, Camille</au><au>Patry, Simon</au><au>Gagné, Christian</au><au>Lemasson, Morgane</au><au>Gariépy, Geneviève</au><au>Mérette, Chantal</au><au>Rahme, Elham</au><au>Lesage, Alain</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The 5-year longitudinal diagnostic profile and health services utilization of patients treated with electroconvulsive therapy in Quebec: a population-based study</atitle><jtitle>Social Psychiatry and Psychiatric Epidemiology</jtitle><stitle>Soc Psychiatry Psychiatr Epidemiol</stitle><addtitle>Soc Psychiatry Psychiatr Epidemiol</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>58</volume><issue>4</issue><spage>629</spage><epage>639</epage><pages>629-639</pages><issn>0933-7954</issn><eissn>1433-9285</eissn><abstract>Purpose
Electroconvulsive therapy (ECT) is effective for treating several psychiatric disorders. However, only a minority of patients are treated with ECT. It is of primary importance to characterize their profile for epidemiological purposes and to inform clinical practice. We aimed to characterize the longitudinal profile of psychopathology and services utilization of patients first treated with ECT.
Methods
We conducted a population-based comparative study using data from a national administrative database in Quebec. Patients who received a first ECT between 2002 and 2016 were compared to controls who were hospitalized in psychiatry but did not receive ECT. We performed descriptive analyses to compare psychiatric diagnoses, domains of psychopathology (internalizing, externalizing and thought/psychotic disorders), medical services and medication use in the 5 years prior to the ECT or hospitalization.
Results
5 080 ECT patients were compared with 179 594 controls. Depressive, anxiety, bipolar and psychotic disorders were more frequent in the ECT group. 96.2% of ECT patients had been diagnosed with depression and 53.8% with a primary psychotic disorder. In the ECT group, 1.0% had been diagnosed exclusively with depression and 47.0% had disorders from that belong to all three domains of psychopathology. Having both internalizing and thought/psychotic disorders was associated with an increased likelihood of receiving ECT vs having internalizing disorders alone (unadjusted OR = 2.93; 95% CI = 2.63, 3.26). All indicators of mental health services utilization showed higher use among ECT patients.
Conclusion
Our results provide robust evidence of complex longitudinal psychopathology and extensive services utilization among ECT patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36163429</pmid><doi>10.1007/s00127-022-02369-w</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-0704-4754</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0933-7954 |
| ispartof | Social Psychiatry and Psychiatric Epidemiology, 2023-04, Vol.58 (4), p.629-639 |
| issn | 0933-7954 1433-9285 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Analysis Bipolar Disorder - therapy Care and treatment Comparative studies Depression, Mental Disorders Domains Electroconvulsive Therapy Epidemiology Facilities and Services Utilization Health care industry Health services Health services utilization Humans Medical care Medicine Medicine & Public Health Mental depression Mental health Observational studies Original Paper Population-based studies Psychiatric services Psychiatry Psychology, Pathological Psychopathology Psychosis Psychotic Disorders - diagnosis Psychotic Disorders - epidemiology Psychotic Disorders - therapy Quebec - epidemiology Utilization |
| title | The 5-year longitudinal diagnostic profile and health services utilization of patients treated with electroconvulsive therapy in Quebec: a population-based study |
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