PRediction Of Treatment Response to ECT in Depression and Cognitive Side effecTs

NCT ID: NCT02562846

Last Updated: 2018-05-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

74 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-06-30

Study Completion Date

2018-02-28

Brief Summary

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It has been convincingly demonstrated that electroconvulsive therapy (ECT) works better and sooner than antidepressants in the treatment of certain subtypes of depression. Given this effectiveness, it would be unfortunate not to give ECT to patients with good response chances as this could substantially shorten the length of a severe depressive episode. Instead of going through all possible psychopharmacological treatment steps, ECT could be proposed much earlier as a treatment option for those patients who might have good response chances. This would be a great advantage for the severely depressed patient, with a decreased disease-burden and hospitalization duration.

However, up to now, objective and reliable predictive factors for good ECT response have not yet been established. Clinical characteristics such as psychomotor retardation, psychotic features and age have often been used to predict the outcome of ECT, but there is too little evidence to consider these as strong predictive factors.

The current project is designed to allow better prediction of ECT-response. The investgators base their selection of predictors on clinical impression and previous research results. The predictive capacity of psychomotor functioning, psychotic symptoms and several biomarkers will be investigated. With these clinical and biological patient and depression characteristics, the investigators aim to develop a decision making tool that will allow a more accurate indication of ECT.

The investigators also investigate ways to predict whether or not a patient will have a good response when treatment has already started, based on an early improvement of psychomotor functioning.

Another subject of great importance is predicting and preventing side-effects. When patients at risk for lasting cognitive side-effects can be identified early in the treatment course, treatment can be adjusted to prevent persistence of memory problems. Therefore, the second part of the study focuses on identifying people at risk for cognitive side effects early in the treatment course.

Detailed Description

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Conditions

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Depression

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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ECT patients

Depressive patients receiving electroconvulsive therapy.

Psychological testing and biological sample collection

Intervention Type OTHER

For this study, there will be psychological tests, blood and hair sample collections, and part of the patients will undergo an MRI.

Interventions

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Psychological testing and biological sample collection

For this study, there will be psychological tests, blood and hair sample collections, and part of the patients will undergo an MRI.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Admitted to PZ Duffel and eligible for ECT because of major depressive disorder of major depressive episode in bipolar disorder (according to DSM-5 criteria).
* Score on HDRS ≥ 17.
* Have signed an IC form indicating that they understand the purpose of and procedures required for the study and are willing to participate in this study. In case of incapacity, a close relative will be asked to give informed consent.
* Be medically stable on the basis of physical examination and vital signs performed during the pre-ECT screening procedure.

Exclusion Criteria

* Drug or alcohol dependence as detected in the MINI interview at screening (\<6 months before ECT).
* Primary psychotic disorder according to DSM-5 criteria (\<6 months before ECT).
* Is currently enrolled in a study with an investigational study drug.
* Has any condition that, in the opinion of the investigator, would compromise the wellbeing of the subject or the study or prevent the subject from meeting or performing study requirements.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universiteit Antwerpen

OTHER

Sponsor Role lead

Responsible Party

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Linda van Diermen

Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bernard Sabbe, MD, prof.

Role: STUDY_DIRECTOR

Duffel Psychiatric Hospital

Locations

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PZ Duffel

Duffel, Antwerp, Belgium

Site Status

Countries

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Belgium

References

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van Diermen L, Poljac E, Van der Mast R, Plasmans K, Van den Ameele S, Heijnen W, Birkenhager T, Schrijvers D, Kamperman A. Toward Targeted ECT: The Interdependence of Predictors of Treatment Response in Depression Further Explained. J Clin Psychiatry. 2020 Dec 15;82(1):20m13287. doi: 10.4088/JCP.20m13287.

Reference Type DERIVED
PMID: 33326710 (View on PubMed)

Hebbrecht K, Giltay EJ, Birkenhager TK, Sabbe B, Verwijk E, Obbels J, Roelant E, Schrijvers D, Van Diermen L. Cognitive change after electroconvulsive therapy in mood disorders measured with the Montreal Cognitive Assessment. Acta Psychiatr Scand. 2020 Nov;142(5):413-422. doi: 10.1111/acps.13231. Epub 2020 Sep 21.

Reference Type DERIVED
PMID: 32895922 (View on PubMed)

Baeten RF, Van Rossum EFC, De Rijke YB, Sabbe BGC, Van Der Mast RC, Belge JB, Fransen E, Schrijvers DL, Birkenhager TK, Van Diermen L. Hair cortisol in patients with a depressive episode treated with electroconvulsive therapy. J Affect Disord. 2020 Sep 1;274:784-791. doi: 10.1016/j.jad.2020.05.042. Epub 2020 May 28.

Reference Type DERIVED
PMID: 32664015 (View on PubMed)

Belge JB, Van Diermen L, Schrijvers D, Sabbe B, Constant E, de Timary P, De Keyzer S, Parizel P, Vansteelandt K, Sienaert P, van Eijndhoven P. The basal ganglia: A central hub for the psychomotor effects of electroconvulsive therapy. J Affect Disord. 2020 Mar 15;265:239-246. doi: 10.1016/j.jad.2020.01.033. Epub 2020 Jan 13.

Reference Type DERIVED
PMID: 32090747 (View on PubMed)

van Diermen L, Versyck P, van den Ameele S, Madani Y, Vermeulen T, Fransen E, Sabbe BGC, van der Mast RC, Birkenhager TK, Schrijvers D. Performance of the Psychotic Depression Assessment Scale as a Predictor of ECT Outcome. J ECT. 2019 Dec;35(4):238-244. doi: 10.1097/YCT.0000000000000610.

Reference Type DERIVED
PMID: 31764446 (View on PubMed)

van Diermen L, Hebbrecht K, Schrijvers D, Sabbe BCG, Fransen E, Birkenhager TK. The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression. Acta Psychiatr Scand. 2018 Dec;138(6):605-614. doi: 10.1111/acps.12962. Epub 2018 Oct 1.

Reference Type DERIVED
PMID: 30270433 (View on PubMed)

Other Identifiers

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B300201524466

Identifier Type: -

Identifier Source: org_study_id

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