Electroconvulsive therapy (ECT) reduces the risk of suicide among inpatients with severe depression.
Putting It Into Practice
The risk of suicide is elevated in patients with depression following psychiatric hospital discharge. The risk of suicide can linger for years, but patients are especially at risk during the first 3 months following discharge.
ECT has been shown to ameliorate the risk of suicide for at least 12 months following hospital discharge for severe depression.
Why this study matters
Major depressive disorder is associated with co-morbidities, such as cardiovascular diseases, cerebrovascular diseases, hypertension, diabetes, autoimmune diseases, and immunologic dysfunction, as well as an increased risk for suicide.
ECT is the most effective treatment option for patients with psychotherapy and/or pharmacologic treatment-resistant MDD, and results in symptomatic improvement in at least 50% of patients, including a significant reduction in suicide.
This was a retrospective study involving adults admitted to a psychiatric hospital for depression who were treated with ECT.
The primary outcome was death by suicide within 1 year of discharge from the hospital. The secondary outcomes were non-suicide deaths and all-cause mortality.
Results and conclusion
Of 67,327 psychiatric hospital admissions for depression, 4982 patients received ECT.
The risk for suicide within 1 year following hospital discharge was significantly reduced in the patients treated with ECT compared to the patients who were not treated with ECT (HR = 0.53).
The risk for all-cause mortality (HR = 0.75), but not non-suicide deaths (HR = .83), was also lower among the patients treated with ECT.
Kaster TS, Blumberger DM, Gomes T, et al. Risk of suicide death following electroconvulsive therapy treatment for depression: A propensity score-weighted, retrospective cohort study in Canada. American Journal of Psychiatry 2022;9:435-46.