Gender differences in electroconvulsive therapy: a retrospective chart review

Background: There is a growing interest in gender differences of different psychiatric disorders, especially major depression. We sought a possible gender difference related to electroconvulsive therapy (ECT). Methods: This retrospective study compared 20 male and 23 female depressed adult patients treated by ECT. We compared their findings on gender differences to those of 12 female and 4 male bipolar patients and 11 male and 19 female schizophrenic patients, all treated in the same ECT setting. Results: Depressed female patients underwent significantly fewer antidepressant drugs trials than males before being referred to ECT (t((41))=2.09, P<0.05). A similar gender difference was found in the treatment of patients suffering from schizophrenia: female patients underwent fewer pharmacological antipsychotic trials than males before being referred to ECT (t((2S))=3.11, P<0.01). ECT was significantly more effective in female patients than in male patients suffering from schizophrenia (U=38, P<0.05). Limitations: This is a retrospective pilot study whose results are based on subjective evaluations. Conclusion: The findings of this study may support a gender difference both in referral and in the outcome of ECT. Clinical relevance: there might be a need to consider lowering the number of pre-ECT drug trials for depressed males and to consider ECT as a viable therapeutic option for schizophrenic females. (C) 2004 Elsevier B.V. All rights reserved.