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NATASHA BOWMAN QUEEN’S UNIVERSITY DEPARTMENT OF PSYCHOLOGY KINGSTON, ONTARIO Gender and the Efficacy of Electroconvulsive Therapy for Major Depressive Disorder
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NATASHA BOWMAN QUEEN’S UNIVERSITY
DEPARTMENT OF PSYCHOLOGYKINGSTON, ONTARIO
Gender and the Efficacy of Electroconvulsive Therapy for
Major Depressive Disorder
Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD)
Occurs along a continuum
Major Depressive Disorder (MDD)
Occurs along a continuumCore symptoms of MDD:
Major Depressive Disorder (MDD)
Occurs along a continuumCore symptoms of MDD:
Sad, irritable, or anxious mood
Major Depressive Disorder (MDD)
Occurs along a continuumCore symptoms of MDD:
Sad, irritable, or anxious mood Loss of interest or pleasure
Major Depressive Disorder (MDD)
Occurs along a continuumCore symptoms of MDD:
Sad, irritable, or anxious mood Loss of interest or pleasure Impaired concentration and decision making
Major Depressive Disorder (MDD)
Occurs along a continuumCore symptoms of MDD:
Sad, irritable, or anxious mood Loss of interest or pleasure Impaired concentration and decision making Etc.
Major Depressive Disorder (MDD)
Electroconvulsive therapy (ECT)
Electroconvulsive therapy (ECT)
Cerebral seizure under general anesthesia
Electroconvulsive therapy (ECT)
Cerebral seizure under general anesthesiaDo not respond to antidepressants
Electroconvulsive therapy (ECT)
Cerebral seizure under general anesthesiaDo not respond to antidepressantsReferral determined by clinical features
Electroconvulsive therapy (ECT)
Cerebral seizure under general anesthesiaDo not respond to antidepressantsReferral determined by clinical features+/- 12 treatments 3x per week
Efficacy of ECT
Remission Relapse
Efficacy of ECT
Efficacy of ECT
Community hospitals: less effective?
Efficacy of ECT
Community hospitals: less effective?Mechanism of efficacy? hormones,
dopamine, serotonin, grey matter activity
Efficacy of ECT
Community hospitals: less effective?Mechanism of efficacy? hormones,
dopamine, serotonin, grey matter activitySpeed of response: 60% remit by session
#9
Efficacy of ECT
Community hospitals: less effective?Mechanism of efficacy? hormones,
dopamine, serotonin, grey matter activitySpeed of response: 60% remit by session
#9Durability of response:
maintenance treatment indicated
Rationale for present research
Rationale for present research
Gender differences in the post-seizure release of stress hormones
Rationale for present research
Gender differences in the post-seizure release of stress hormones
Gender differences in ECT for schizophrenia
Rationale for present research
Gender differences in the post-seizure release of stress hormones
Gender differences in ECT for schizophreniaGender differences in MDD
The research
The research
Hypothesis:
The research
Hypothesis:Chart review, 157 patients (100 females; 57
males)
Results
Results
One-way ANOVA between gender and # of sessions:
Results
One-way ANOVA between gender and # of sessions: NOT SIGNIFICANT
Results
Chi square: gender difference between ECT treatment refractory and ECT treatment receptive:
Results
Chi square: gender difference between ECT treatment refractory and ECT treatment receptive: NOT SIGNIFICANT
In conclusion ...
In conclusion ...
Confounding variables?
In conclusion ...
Confounding variables? Age
In conclusion ...
Confounding variables? Age Previous medication failure
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities Duration of depressive episode
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities Duration of depressive episode Season of treatment
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities Duration of depressive episode Season of treatment Electrode placement
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities Duration of depressive episode Season of treatment Electrode placement
Maintenance drug therapy?
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities Duration of depressive episode Season of treatment Electrode placement
Maintenance drug therapy?Very important!
In conclusion ...
Confounding variables? Age Previous medication failure Comorbidities Duration of depressive episode Season of treatment Electrode placement
Maintenance drug therapy?Very important!THANK YOU!!! ... Questions?
