{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:47:53Z","timestamp":1787312873260,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether the rates of readmissions and suicide vary in psychotic unipolar depression based on whether patients receive maintenance electroconvulsive therapy (M\u2010ECT) following the initial series of ECT, and to examine if there is an age\u2010dependent association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used Swedish national registries to identify hospitalized patients with psychotic unipolar depression, treated 2008\u20132019 who received ECT during their hospital stay. The patients who received subsequent M\u2010ECT within 14\u2009days after discharge were compared with those who did not. The primary composite outcome was time to readmission due to a psychiatric disorder, suicide attempt, or suicide within 2\u2009years from discharge. Data were analyzed using Cox regression adjusted for previous psychiatric admissions, age, sex, comorbidity, and pharmacological treatment. We also conducted a within\u2010individual analysis using the sign\u2010test, with patients having \u22651 hospital episode followed by M\u2010ECT and \u22651 hospital episode without M\u2010ECT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1873 patients were included, of which 130 received M\u2010ECT. There was no statistically significant group difference regarding the primary outcome in the whole sample. However, when stratified by age, there was a significant difference in favor of M\u2010ECT for patients &gt;65\u2009years (adjusted hazard ratio 0.55, 95% confidence interval 0.35\u20130.87). The within\u2010individual analysis, including 46 patients, significantly favored M\u2010ECT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>M\u2010ECT was not associated with a differential risk of the composite of readmission and suicide in psychotic depression. Among patients &gt;65\u2009years, M\u2010ECT was significantly associated with a decreased risk of the outcome. The possibility of residual confounding cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13711","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T07:19:35Z","timestamp":1716880775000},"page":"148-159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Electroconvulsive therapy in the maintenance phase of psychotic unipolar depression"],"prefix":"10.1111","volume":"150","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1042-0730","authenticated-orcid":false,"given":"Ahmed","family":"Al\u2010Wandi","sequence":"first","affiliation":[{"name":"University Health Care Research Centre, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4496-6451","authenticated-orcid":false,"given":"Mikael","family":"Land\u00e9n","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Physiology The Sahlgrenska Academy at Gothenburg University  Gothenburg Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7454-3065","authenticated-orcid":false,"given":"Axel","family":"Nordenskj\u00f6ld","sequence":"additional","affiliation":[{"name":"University Health Care Research Centre, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Socialstyrelsen. Klassifikation av sjukdomar 1987.Systematisk f\u00f6rteckning. 1. uppl. ed. Stockholm: Socialstyr.: Liber\/Allm\u00e4nna f\u00f6rl. 1986."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717002501"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707000141"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.08.028"},{"key":"e_1_2_10_6_1","unstructured":"Gelenberg AJ Freeman MP Markowitz JC.Practice guideline for the treatment of patients with major depressive disorder. 3rd ed.American Psychiatric Association;2010."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000484"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000914"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2023.05.010"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e318170a6fa"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.12.1337"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31823e2705"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-450"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000243"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0316-1"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1294"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9350-y"},{"key":"e_1_2_10_18_1","volume-title":"IBM SPSS Statistics for Windows, Version 29.0","year":"2021"},{"key":"e_1_2_10_19_1","volume-title":"Version: Enterprise Guide 8.3","author":"SAS Institute","year":"2020"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-021-01301-8"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(00)00242-1"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(01)00451-7"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2017.28"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2021.1990997"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20567"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13277"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881118822161"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3646"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13628"},{"key":"e_1_2_10_30_1","unstructured":"Socialstyrelsen.Nationella riktlinjer f\u00f6r v\u00e5rd vid depression och \u00e5ngestsyndrom.2021."},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2018.07.005"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/13651501.2022.2035771"}],"container-title":["Acta Psychiatrica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acps.13711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T21:39:31Z","timestamp":1722548371000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acps.13711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,28]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/acps.13711"],"URL":"https:\/\/doi.org\/10.1111\/acps.13711","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/ACPS.13711\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/ACPS.13711\/v1\/decision1","asserted-by":"object"}]},"ISSN":["0001-690X","1600-0447"],"issn-type":[{"value":"0001-690X","type":"print"},{"value":"1600-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,28]]},"assertion":[{"value":"2024-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}