ECT in Unipolar and Bipolar Disorders: A Naturalistic Evaluation of 460 Patients

Abstract

We compared the efficacy of electroconvulsive therapy (ECT) and numbers of ECTs received by unipolar depressive (n = 368), bipolar depressive (n = 55), and manic patients (n = 37) in a review of records of patients treated in a 12-year period in a university hospital medical center. Both unipolar and bipolar depressive patients received nine treatments, one half more on average than the number of treatments received by manic patients, but the difference was not significant. ECT was equally effective in unipolar and bipolar depression (69.8 and 69.1%, respectively, rated as "markedly improved"), whereas 78.4% of patients with mania had "marked improvement." Both unilateral and bilateral ECTs were equally effective for the three groups. Bipolar depressive and manic patients receiving mixed courses (some unilateral, some bilateral) received more treatments than did those receiving unilateral or bilateral treatments exclusively and tended not to respond as well. We conclude that ECT is an effective treatment for mania, unipolar, and bipolar depression, that unilateral and bilateral treatments are equally effective, and that no significant difference exists in the number of ECTs used to treat these disorders.