Depression Remission and Response Rates and Anxiety Response as a Predictor of Depression Response in a Community Electroconvulsive Therapy Clinic.

To assess depression response and remission rates with electroconvulsive therapy (ECT) in a community clinic and to identify factors predicting success in treatment. Thirty-five patients were identified by a retrospective chart review with a diagnosis of major depressive disorder or depressive disorder not otherwise specified (according to the ) who were treated with an acute series of ECT at a community ECT clinic from March 1, 2014, to March 9, 2015. Logistic regression examined associations between clinical variables and depression response (defined as ≥50% reduction in score on the Patient Health Questionnaire-9 [PHQ-9]) and remission (final PHQ-9 score <5) rates and anxiety response rates (based on the Generalized Anxiety Disorder 7 item). Depression response and remission rates were 54.3% and 31.4%, respectively. This was a highly treatment-resistant sample, with an average of 5.3 antidepressant trials prior to initiating ECT. Improvement in anxiety symptoms was associated with depression response (odds ratio: 1.41, 95% CI, 1.11-1.78). Additionally, patients with initial severe anxiety scores were less likely than other patients to exhibit a response in depression (=.027). Almost half of this sample of patients with treatment-resistant depression did not respond to ECT in this community-based clinic, highlighting the challenges of treating this condition. Comorbid anxiety symptoms may reduce the likelihood of depression response, as patients with severe anxiety were less likely to respond. .