{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T14:40:00Z","timestamp":1792852800925,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Continuation and maintenance ECT (c\u2010\/m\u2010ECT) are effective in the prevention of relapse and recurrence of both affective and psychotic disorders. However, data are scarce concerning the trajectories of severe mental disorders after the end of c\u2010\/m\u2010ECT. This prospective study investigates the clinical outcome of patients with versus without modifications of their c\u2010\/m\u2010ECT schedules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In the context of the COVID\u201019 pandemic, ECT capacities were restricted at many clinics in early 2020. All patients receiving c\u2010\/m\u2010ECT in March and April 2020 at our department (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a053, unipolar depression, bipolar disorder, schizophrenia) were followed up for six months to investigate the impact of treatment modifications imposed by the pandemic. Based on individual decisions, c\u2010\/m\u2010ECT was either (a) continued without modification, (b) continued with reduced frequency, or (c) discontinued.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both reduced frequency and discontinuation of c\u2010\/m\u2010ECT were associated with significant clinical deterioration as measured by CGI\u2010I (Clinical Global Impression Scale \u2010 Global Improvement) during the six\u2010month follow\u2010up when compared to the subgroup of patients without any treatment modification (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.011). Furthermore, patients with discontinued or reduced c\u2010\/m\u2010ECT showed significantly higher rates of rehospitalizations (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.028) and new acute courses of ECT (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the limitations of a heterogeneous and relatively small sample, our study strongly corroborates the effectiveness of c\u2010\/m\u2010ECT in a real\u2010world population. Especially, patients with shorter time since index ECT seem to be at high risk for severe clinical deterioration in the case of treatment discontinuation or reduction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13314","type":"journal-article","created":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T15:18:09Z","timestamp":1620487089000},"page":"238-245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Effectiveness of maintenance electroconvulsive therapy\u2014Evidence from modifications due to the COVID\u201019 pandemic"],"prefix":"10.1111","volume":"144","author":[{"given":"Isabel","family":"Methfessel","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Besse","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Belz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7531-9732","authenticated-orcid":false,"given":"David","family":"Zilles\u2010Wegner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center G\u00f6ttingen G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00124509-200403000-00004"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2014.13060787"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X14666161017233642"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2013.149"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867417743343"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328943"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.03.033"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000588"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000484"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.16010118"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e318276591f"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000693"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpsm.2019.07.001"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2020.08.001"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000713"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","unstructured":"GuyW.ECDEU assessment manual for psychopharmacology. 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