PRediction Of Treatment Response to ECT in Depression and Cognitive Side effecTs
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Observational [Patient Registry]

Summary: 
      It has been convincingly demonstrated that electroconvulsive therapy (ECT) works better and
      sooner than antidepressants in the treatment of certain subtypes of depression. Given this
      effectiveness, it would be unfortunate not to give ECT to patients with good response chances
      as this could substantially shorten the length of a severe depressive episode. Instead of
      going through all possible psychopharmacological treatment steps, ECT could be proposed much
      earlier as a treatment option for those patients who might have good response chances. This
      would be a great advantage for the severely depressed patient, with a decreased
      disease-burden and hospitalization duration.

      However, up to now, objective and reliable predictive factors for good ECT response have not
      yet been established. Clinical characteristics such as psychomotor retardation, psychotic
      features and age have often been used to predict the outcome of ECT, but there is too little
      evidence to consider these as strong predictive factors.

      The current project is designed to allow better prediction of ECT-response. The investgators
      base their selection of predictors on clinical impression and previous research results. The
      predictive capacity of psychomotor functioning, psychotic symptoms and several biomarkers
      will be investigated. With these clinical and biological patient and depression
      characteristics, the investigators aim to develop a decision making tool that will allow a
      more accurate indication of ECT.

      The investigators also investigate ways to predict whether or not a patient will have a good
      response when treatment has already started, based on an early improvement of psychomotor
      functioning.

      Another subject of great importance is predicting and preventing side-effects. When patients
      at risk for lasting cognitive side-effects can be identified early in the treatment course,
      treatment can be adjusted to prevent persistence of memory problems. Therefore, the second
      part of the study focuses on identifying people at risk for cognitive side effects early in
      the treatment course.
    


Intervention name(s): Psychological testing and biological sample collection
Intervention type(s): Other
Intervention description(s): For this study, there will be psychological tests, blood and hair sample collections, and part of the patients will undergo an MRI.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The investigators include a severely depressed patient population that has to be evaluated
        regularly. For that reason, the investigators choose residential patients. They are
        recruited at the psychiatric hospital in Duffel.

        Treating psychiatrists consider a candidate eligible for ECT and start pre-ECT
        investigations. The investigators screen all depressive ECT patients for inclusion in the
        study and ask for their informed consent (IC). The treating psychiatrist decides when ECT
        is stopped considering clinical evolution and side effects.
      
Biospecimen description: 
      Whole blood
    
Keywords: electroconvulsive therapy; response prediction; cognitive side effects