Electroconvulsive Maintenance Therapy For Depression: A Meta-analysis

Objective:Objective to compare the efficacy and safety of electroconvulsive maintenance therapy and simple drug therapy in the prevention of relapse and relapse of depression by Meta-analysis.Methods:Search CNKI,sinomed,Wanfang medical network,VIP,Pro Quest,web of science,Pub Med,Science Direct and other databases.The key words "electroconvulsive therapy,continuous electroconvulsive therapy,maintenance electroconvulsive therapy,depressive disorder,depression" and its English "electroconvulsive therapy,electroconvulsive maintenance therapy,continuation electroconvulsive therapy,maintenance electroconvulsive therapy,depression,depressive disorder" were searched.The NOS scale was used to assess the risk of bias in each study.Stata 15 software was used for analysis.Results:Finally,8 studies were included,including 6 randomized controlled trials,1prospective cohort study and 1 retrospective controlled study.Among them,5 were high quality studies and 3 were medium quality studies.There was no significant difference in recurrence and relapse between maintenance therapy group and drug therapy group(RR= 0.49,95% CI = [0.61,1.34],P = 0.627,I2 = 68.6%);there was no significant difference between maintenance therapy group and drug therapy group(RR = 1.50,95% CI = [0.41,1.12],P = 0.133)In randomized controlled trials,there was a significant difference between the two groups(RR = 2.13,95% CI = [0.34,0.95],P = 0.03,I2 = 32.4%).There was a significant difference in 6-month recurrence rate between the two groups(RR =2.16,95% CI = [0.40,0.96],P = 0.03,I2 = 0%).There was no significant difference in long-term recurrence and relapse data between the two groups(RR = 1.77,95% CI =[0.43,1.05],P = 0.03,I2 = 16.1%);there was no significant difference in shedding rate between the two groups(RR = 0.17,95% CI = [0.73,1.46],P = 0.86,I2 = 0%)Test test showed no publication bias(t = 2.16,P = 0.19).Conclusion:Current studies have shown that there is no significant difference in short-term or long-term efficacy between maintenance therapy and drug therapy.However,some randomized controlled trials show that the efficacy of maintenance therapy combined with drug therapy is better than that of drug therapy.There was no significant difference in cognitive function and other adverse events between the two groups.