ECT did not decrease risk for death by suicide compared with other mental health care
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The risk of suicide mortality was similar in patients treated with electroconvulsive therapy and matched controls, with no evidence that the therapy decreased risk of death by suicide, results of a recent study showed.
“Early studies of the impact of ECT on suicide deaths were conducted in an era during which effective psychotropic medication was limited or inaccessible to most patients,” Bradley V. Watts, MD, MPH, of the department of psychiatry at Geisel Medical School at Dartmouth College, and colleagues wrote in the Journal of Clinical Psychiatry. “Though these studies demonstrated protective effects of ECT for suicide deaths, they are difficult to extrapolate to contemporary cohorts of patients.”
Watts and fellow researchers aimed to examine associations of exposure to ECT with risk of death by suicide in a representative sample of current patients. Their study utilized electronic medical record data from the Department of Veterans Affairs health system, between 2000 and 2017, to include 5,157 index courses of ECT therapy, along with 10,097 matched controls who did not receive ECT.
Researchers compared all-cause and suicide mortality among patients who received an index course of ECT with a comparison group created through propensity score matching. Mortality was measured and analyzed for ECT and controls at both 30 and 365 days.
Results showed that the suicide death rate for those who received ECT was 137.34 deaths per 10,000 in 30 days and 804.39 per 10,000 in 365 days. The rate of death by suicide in the control group was 138.65 per 10,000 in 30 days and 564.52 per 10,000 in 1 year. The relative risk of death by suicide comparing those receiving ECT with the matched group was 0.96 (95% CI, 0.38–1.55) in 30 days and 1.38 (95% CI, 0.88–1.87) in 1 year.
“ECT does not appear to have a greater effect on decreasing the risk for suicide than other types of mental health treatment provided to patients with similar risk,” Watts and colleagues wrote.