Maintenance Electroconvulsive Therapy and hospital re-admission days among patients with mental illness in Malaysia

Abstract

AbstractBackgroundRelapse prevention strategies are important as part of optimal patient care. As such, maintenance electroconvulsive therapy (mECT) is an important treatment modality to keep patients in remission longer. However, the practice of mECT in Malaysia, specifically and Asia generally, is still scarce.AimsOur study aimed to explore the characteristics of patients receiving maintenance ECT (mECT) and further investigate whether this treatment modality reduces re-admission days in patients with severe mental illness.MethodsA retrospective chart review study design was employed. The medical records of 22 patients followed up at University Malaya Medical Centre, Malaysia were analysed with regards to the outcome measures, which was days of re-admission post mECT, Potential confounders were controlled for via stratification analysis.ResultsThere was a significant reduction in re-admission days post mECT (p<0.001, r:0.85) across all the variables analysed. The variable with the biggest effect size were patients younger than 60 years old (p:0.01, r:0.70), followed by medication with polypharmacy (p:0.002, r: 0.65). The magnitude of reduction in re-admissions was greater in the schizophrenia spectrum group compared to the affective disorders group (r: 0.64 vs. 0.57).ConclusionOur study provides data regarding the efficacy of mECT in significantly reducing days of re-admission in patients with treatment resistant schizophrenia spectrum illness and affective disorders. As widespread usage of mECT is still lacking in Asia, our results is encouraging for more practitioners to prescribe mECT for their patients in order to reduce rates of hospital re-admission.