Patients Receiving 100 or More Electroconvulsive Therapy Treatments in a Nationwide Cohort

Vollständiger Abstract

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Key Points Significant outcomes In this nationwide cohort, 1% of electroconvulsive therapy recipients received 100 or more treatments, representing an identifiable subgroup of electroconvulsive therapy recipients. Patients receiving 100 or more treatments had treatment durations of several years and substantially more psychiatric hospitalizations and cumulative hospitalization days, indicating prolonged and recurrent psychiatric care. Clozapine use increased across cumulative electroconvulsive therapy exposure categories, although the clinical significance of this association could not be determined from claims data. Limitations Treatment intent could not be determined from claims data; therefore, acute, continuation, and maintenance electroconvulsive therapy could not be reliably distinguished. Hospital‐specific patient identifiers prevented linkage across institutions, potentially resulting in duplicate patient records and incomplete ascertainment of cumulative electroconvulsive therapy exposure. Claims data lacked detailed clinical information, including treatment response and cognitive outcomes, limiting assessment of the long‐term tolerability and clinical context of repeated electroconvulsive therapy.