{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:44:41Z","timestamp":1790045081069,"version":"4.0.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T00:00:00Z","timestamp":1698537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess electroconvulsive therapy (ECT) outcomes in patients affected by depressive symptoms with versus without additional comorbid personality disorders\/traits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified observational studies investigating ECT clinical outcomes in patients affected by depressive symptoms with versus without comorbid personality disorders\/traits in Embase\/Medline in 11\/2022. Our protocol was registered with PROSPERO (CRD42023390833). Study quality was evaluated using the Newcastle\u2010Ottawa\u2010Scale. Our primary outcomes were ECT response and remission rates. Meta\u2010regression analyses included effects of in\/outpatient percentages, age, number of ECT sessions, and electrode placement; subgroup analyses included the assessment methods for personality disorders\/traits. We performed sensitivity analyses after excluding poor\u2010quality studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 20 studies (<jats:italic>n<\/jats:italic>\u2009=\u200911,390) were included in our analysis. Patients with comorbid personality disorders\/traits had lower remission rates (OR\u2009=\u20090.42, 95% CI\u2009=\u20090.31, 0.58, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with substantial heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200993.0%) as well as lower response rates (OR\u2009=\u20090.35, 95% CI\u2009=\u20090.24, 0.51, <jats:italic>n<\/jats:italic>\u2009=\u20095129, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with substantial heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200993.0%) compared with patients without comorbid personality disorders\/traits. Relapse rates were higher in patients with versus without comorbid personality disorders\/traits (OR\u2009=\u20093.23, 95% CI\u2009=\u20091.40, 7.45, <jats:italic>k<\/jats:italic>\u2009=\u20094, <jats:italic>n<\/jats:italic>\u2009=\u2009239, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) with moderate heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200975.0%) and post\u2010ECT memory impairment was more frequent in patients with versus without comorbid personality disorders\/traits (OR\u2009=\u20091.41, 95% CI\u2009=\u20091.36, 1.46, <jats:italic>k<\/jats:italic>\u2009=\u20094, <jats:italic>n<\/jats:italic>\u2009=\u2009471, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with minimal heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.0%). Dropout rates were higher in patients with versus without comorbid personality disorders\/traits (OR\u2009=\u20091.58, 95% CI\u2009=\u20091.13, 2.21, <jats:italic>k<\/jats:italic>\u2009=\u20093, <jats:italic>n<\/jats:italic>\u2009=\u20096145, <jats:italic>p<\/jats:italic>\u2009=\u20090.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with comorbid personality disorders\/traits treated with ECT are reported to have lower response and remission rates and higher rates of side effects and relapse rates compared with patients without personality disorders\/traits.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.13631","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T04:30:54Z","timestamp":1698640254000},"page":"18-32","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Outcomes of electroconvulsive therapy in patients with depressive symptoms with versus without comorbid personality disorders\/traits: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"149","author":[{"given":"Stefano","family":"Ferrea","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics Hospital of Psychiatry, University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3851-4117","authenticated-orcid":false,"given":"Georgios","family":"Petrides","sequence":"additional","affiliation":[{"name":"The Zucker Hillside Hospital, Psychiatry Research, Northwell Health  Glen Oaks New York USA"},{"name":"The Hofstra Northwell School of Medicine  Hempstead New York USA"},{"name":"The Feinstein Institute for Medical Research  Manhasset New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamina","family":"Ehrt\u2010Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, 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