{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:04:32Z","timestamp":1791864272223,"version":"4.3.4"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Electroconvulsive therapy (ECT), wherein a generalized epileptic seizure is induced, is a treatment for major depressive disorder (MDD). Currently, it is unclear whether there is an association between seizure length and treatment outcome.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To explore the association between seizure duration, potential confounding variables, and ECT treatment outcome.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based cohort study obtained data from the Swedish National Quality Register for ECT. Patients treated for unipolar MDD with unilateral electrode placement between January 1, 2012, and December 31, 2019, were included. The electroencephalographic (EEG) seizure duration from the first ECT treatment session for each patient was used for analysis. Data analyses were performed between March 2021 and May 2024.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was remission, defined as a cutoff score of less than 10 points on the self-assessment version of the Montgomery-\u00c5sberg Depression Rating Scale within 1 week after ECT. Multivariate logistic regression analysis was performed to calculate odds ratios (ORs) between different seizure duration groups. Furthermore, the associations between concomitant use of pharmacological treatments, seizure duration, and remission rate were explored.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 6998 patients included, 4229 (60.4%) were female and the mean (SD) age was 55.2 (18.6) years. Overall, 2749 patients (39.3%) achieved remission after ECT. Patients with EEG seizure duration of 60 to 69 seconds had the highest remission rates compared with patients with seizure duration of less than 20 seconds (OR, 2.17; 95% CI, 1.63-2.88;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Anticonvulsant medications were associated with shorter seizure duration (eg, lamotrigine: \u03b2 coefficient [SE], \u22126.02 [1.08];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and lower remission rates (eg, lamotrigine: adjusted OR, 0.67; 95% CI, 0.53-0.84;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This study found an association between seizure length and remission from MDD. Use of anticonvulsant medication during ECT was associated with shorter seizure duration and lower remission rates after ECT.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.22738","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T11:48:06Z","timestamp":1721908086000},"page":"e2422738","source":"Crossref","is-referenced-by-count":48,"title":["Seizure Duration and Electroconvulsive Therapy in Major Depressive Disorder"],"prefix":"10.1001","volume":"7","author":[{"given":"Cecilia","family":"Gillving","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health, University Health Care Research Centre, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl Johan","family":"Ekman","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"},{"name":"Stockholm Health Care Services, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5sa","family":"Hammar","sequence":"additional","affiliation":[{"name":"Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway"},{"name":"Department of Clinical Sciences, Division of Adult Psychiatry Faculty of Medicine, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Land\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Lundberg","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"},{"name":"Stockholm Health Care Services, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouya","family":"Movahed Rad","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Division of Adult Psychiatry Faculty of Medicine, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Nordanskog","sequence":"additional","affiliation":[{"name":"Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Psychiatry, Region \u00d6sterg\u00f6tland, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"von Knorring","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, 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