{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:45:22Z","timestamp":1773297922609,"version":"3.50.1"},"reference-count":56,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T00:00:00Z","timestamp":1562544000000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007217","name":"Kaohsiung Municipal Kai-Syuan Psychiatric Hospital","doi-asserted-by":"publisher","award":["KSPH-2008-12"],"award-info":[{"award-number":["KSPH-2008-12"]}],"id":[{"id":"10.13039\/501100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST-103-2314-B-280-001-MY3"],"award-info":[{"award-number":["MOST-103-2314-B-280-001-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated the efficacy of electroconvulsive therapy in patients with major depressive disorder and concomitant anxiety symptoms and explored the relationships between depression symptoms and anxiety symptoms during acute electroconvulsive therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Major depressive disorder inpatients (N\u2009=\u2009130) requiring electroconvulsive therapy were recruited for a maximum of 12 treatments each. Depression symptoms, using the core factor subscale derived from the 17-item Hamilton Depression Rating Scale, and anxiety symptoms, using the anxiety\/somatization subscale from the Hamilton Depression Rating Scale-17, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both core factor subscale and anxiety\/somatization subscale scores were converted to T-score units to compare the degrees of changes between depression symptoms and anxiety symptoms after electroconvulsive therapy. The relationships between core factor subscale and anxiety\/somatization subscale were analyzed using the cross-lagged longitudinal model during acute electroconvulsive therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total 116 patients who completed at least the first 3 electroconvulsive therapy treatments were included in the analysis. Reduction of core factor scale T-scores was significantly greater than that of anxiety\/somatization subscale T-scores. The model satisfied all indices of goodness-of-fit (chi-square\u2009=\u200930.204, df\u2009=\u200924, P\u2009=\u20090.178, Tucker-Lewis Index\u2009=\u20090.976, Comparative Fit Index\u2009=\u20090.989, Root Mean Square Error of Approximation\u2009=\u20090.047). Core factor subscale changes did not definitely predict subsequent anxiety\/somatization subscale changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Electroconvulsive therapy is effective in the acute treatment of major depressive disorder patients associated with anxiety symptoms. Anxiety symptoms improved less than depression symptoms during acute electroconvulsive therapy. However, earlier reduction in depression symptoms does not definitely drive subsequent relief in anxiety symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ijnp\/pyz038","type":"journal-article","created":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T11:09:59Z","timestamp":1562584199000},"source":"Crossref","is-referenced-by-count":5,"title":["The Relationship Between Depression Symptoms and Anxiety Symptoms During Acute ECT for Patients With Major Depressive Disorder"],"prefix":"10.1093","author":[{"given":"Chun-Jen","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan"},{"name":"Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Hua","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan"},{"name":"Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyh-I","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Cheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,8]]},"reference":[{"key":"2019080714451153700_CIT0001","volume-title":"American Psychiatric Association: structured clinical interview for DSM-IV","author":"APA","year":"1994"},{"key":"2019080714451153700_CIT0002","volume-title":"The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging: a task force report of the American Psychiatric Association","author":"APA","year":"2001","edition":"2"},{"key":"2019080714451153700_CIT0003","first-page":"158","article-title":"Can we distinguish anxiety from depression?","volume":"36","author":"Baldwin","year":"2002","journal-title":"Psychopharmacol Bull"},{"key":"2019080714451153700_CIT0004","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/da.20141","article-title":"Escitalopram in the treatment of anxiety symptoms associated with depression","volume":"24","author":"Bandelow","year":"2007","journal-title":"Depress Anxiety"},{"key":"2019080714451153700_CIT0005","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1017\/S1461145701002565","article-title":"Meta-analysis of placebo-controlled trials with mirtazapine using the core items of the Hamilton Depression Scale as evidence of a pure antidepressive effect in the short-term treatment of major depression","volume":"4","author":"Bech","year":"2001","journal-title":"Int J Neuropsychopharmacol"},{"key":"2019080714451153700_CIT0006","doi-asserted-by":"crossref","first-page":"207","DOI":"10.31887\/DCNS.2006.8.2\/pbech","article-title":"Rating scales in depression: limitations and pitfalls","volume":"8","author":"Bech","year":"2006","journal-title":"Dialogues Clin Neurosci"},{"key":"2019080714451153700_CIT0007","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/j.1600-0447.1981.tb00676.x","article-title":"The Hamilton depression scale. 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