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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Neurostimulation
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1491451
This article is part of the Research Topic Treatment Resistant Depression (TRD): epidemiology, clinic, burden and treatment View all 19 articles

MADRS single items differential changes among patients with melancholic and unspecified depression treated with ECT: an exploratory study.

Provisionally accepted
Beatriz Pozuelo Moyano Beatriz Pozuelo Moyano *Setareh Ranjbar Setareh Ranjbar Kevin Swierkosz-Lenart Kevin Swierkosz-Lenart Jean Pierre Schuster Jean Pierre Schuster Leonardo Zullo Leonardo Zullo Armin Von Gunten Armin Von Gunten Pierre Vandel Pierre Vandel
  • Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

The final, formatted version of the article will be published soon.

    INTRODUCION: Major depressive disorder (MDD) exhibits heterogeneity in treatment response. OBJECTIVES: This exploratory analysis aims to evaluate the differential changes in individual items of the MADRS between melancholic MDD (M-MDD) and unspecified MDD (U-MDD) following electroconvulsive therapy (ECT). METHODS: The study included 23 patients with unipolar MDD who received ECT. Patients were classified as M-MDD or U-MDD according to DSM-5 criteria. MADRS scores were assessed at baseline and one month post-ECT. Differences between subtypes were analyzed using the Wilcoxon test and multiple linear regression. RESULTS: Among 23 participants receiving ECT for MDD, 10 had M-MDD and 13 had U-MDD. Baseline MADRS items showed significantly higher scores in the M-MDD group, except for reported sadness, suicidal ideation, and concentration difficulties. Total MADRS score reduction was significantly greater in the M-MDD group. This decline was especially pronounced in M-MDD patients for specific items, including apparent sadness, inability to feel, pessimistic thoughts, sleep disturbances, reduced appetite, and concentration difficulties, after adjusting for age and sex. CONCLUSION: MADRS score reductions were more substantial for M-MDD than U-MDD in both total and specific items following one month of ECT. Further research with larger samples is needed to clarify MADRS response differences after ECT between melancholic and unspecified depressive subtypes.

    Keywords: Major Depressive Disorder, Melancholic depression, Unspecified depression, ECT, MADRS

    Received: 04 Sep 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Pozuelo Moyano, Ranjbar, Swierkosz-Lenart, Schuster, Zullo, Von Gunten and Vandel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Beatriz Pozuelo Moyano, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

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