Electroconvulsive Therapy for Suicide Risk in Patients With Depression

In patients with depression, electroconvulsive therapy (ECT) nearly halved the risk of suicide within a year of psychiatric hospital discharge.

Researchers conducted a propensity-score–weighted, retrospective cohort study to investigate the risk of death by suicide after psychiatric hospitalization in patients with depression, comparing those who had and had not been exposed to ECT.

Population-level administrative health data on adults with depression admitted to a psychiatric bed in Ontario, Canada, for more than 3 days from April 2007 through December 2017 was utilized. The study’s primary outcome was death by suicide within 365 days after discharge from the hospital, and its secondary outcomes were death from causes besides suicide and all-cause mortality.

Researchers determined that 67,327 records of psychiatric hospitalization for depression occurred during the study period. These records indicated that 4982 patients had received ECT and 62,345 had not.

Analyses revealed that ECT was associated with a significant decrease in the risk of death by suicide (csHR=0.53; 95% CI, 0.31-0.92). They noted that including death from causes besides suicide as a competing risk in the analysis had no impact on the results.

Moreover, ECT was associated with a significant decrease in the risk of all-cause mortality (csHR=0.75; 95% CI, 0.58-0.97) but not in the risk of death from causes besides suicide (csHR=0.83; 95% CI, 0.61-1.12)

“This study reinforces the importance of electroconvulsive therapy, particularly for people with severe depression,” researchers concluded.

—Ellen Kurek

Reference:

Kaster TS, Blumberger DM, Gomes T, Sutradhar R, Wijeysundera DN, Vigod SN. Risk of suicide death following electroconvulsive therapy treatment for depression: a propensity score-weighted, retrospective cohort study in Canada. Lancet Psychiatry. Published online April 26, 2022. doi:10.1016/S2215-0366(22)00077-3