{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:32:48Z","timestamp":1788978768509,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"St. Joseph's Healthcare Hamilton Professional Advisory Committee Grant"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The effectiveness of ECT under naturalistic conditions has not been well-studied. The current study aimed to 1) characterize a naturalistic sample of ECT patients; and 2) examine the long-term outcomes of ECT on depressive symptoms (Beck Depression Inventory-II; BDI-II) and functional disability symptoms (WHO Disability Assessment Schedule 2.0) in this sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were adults who received ECT for a major depressive episode at an ambulatory ECT clinic between September 2010 and November 2020. Clinical and cognitive assessments were completed at baseline ( n\u2009=\u2009100), mid-ECT ( n\u2009=\u200994), 2\u20134 weeks post-ECT ( n\u2009=\u200964), 6-months post-ECT ( n\u2009=\u200934), and 12-months post-ECT ( n\u2009=\u200919).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, participants had severe levels of depressive symptoms (BDI-II: M\u2009=\u200941.0, SD\u2009=\u20099.4), and 62.9% screened positive for multiple psychiatric diagnoses on the MINI International Neuropsychiatric Interview. Depressive symptoms ( F(4,49.1)\u2009=\u200949.92, P\u2009 &lt;\u20090.001) and disability symptoms ( F(3,40.72)\u2009=\u200912.30, P\u2009 &lt;\u20090.001) improved significantly following ECT, and this was maintained at 12-months follow-up. Improvement in depressive symptoms trended towards significantly predicting reduction in disability symptoms from baseline to post-ECT, ( F(1,56)\u2009=\u20093.67, P\u2009 =\u20090.061). Although our clinical remission rate of 27% (BDI-II score [Formula: see text] 13 and [Formula: see text] 50% improvement) and overall response rate of 41.3% ([Formula: see text]50% improvement in BDI-II score) were lower than the rates reported in the extant RCT and community ECT literature, 36% of those treated with ECT were lost to follow-up and did not complete post-ECT rating scales. At baseline, remitters had significantly fewer psychiatric comorbidities, lower BDI-II scores, and lower disability symptoms than non-responders ( P\u2009&lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants were severely symptomatic and clinically complex. ECT was effective at reducing depressive symptoms and functional disability in this heterogeneous sample. Although a large amount of missing data may have distorted our calculated response\/remission rates, it is also likely that clinical heterogeneity and severity contribute to lower-than-expected remission and response rates to ECT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437211064020","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:18:29Z","timestamp":1639441109000},"page":"351-360","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Naturalistic Study on the Effects of Electroconvulsive Therapy (ECT) on Depressive Symptoms"],"prefix":"10.1177","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-0694","authenticated-orcid":false,"given":"Sarah A.","family":"Goegan","sequence":"first","affiliation":[{"name":"Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada"},{"name":"Clinical Neuropsychology Service, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary M.","family":"Hasey","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"ECT Clinic, St, Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada"},{"name":"Mood Disorders Program, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena P.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada"},{"name":"Clinical Neuropsychology Service, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno J.","family":"Losier","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Bieling","sequence":"additional","affiliation":[{"name":"Clinical Neuropsychology Service, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Mood Disorders Program, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret C.","family":"McKinnon","sequence":"additional","affiliation":[{"name":"Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Mood Disorders Program, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"},{"name":"Homewood Research Institute, Guelph, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather E.","family":"McNeely","sequence":"additional","affiliation":[{"name":"Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada"},{"name":"Clinical Neuropsychology Service, St. Joseph's Healthcare Hamilton (SJHH), Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"bibr1-07067437211064020","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12705-5"},{"key":"bibr2-07067437211064020","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12050648"},{"key":"bibr3-07067437211064020","doi-asserted-by":"publisher","DOI":"10.1097\/00124509-200309000-00005"},{"key":"bibr4-07067437211064020","doi-asserted-by":"publisher","DOI":"10.1176\/foc.6.1.foc155"},{"key":"bibr5-07067437211064020","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2017.28"},{"key":"bibr6-07067437211064020","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2012.00997.x"},{"key":"bibr7-07067437211064020","unstructured":"American Psychiatric Association. 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