Gender differences in electroconvulsive therapy: A retrospective chart review

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). 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. Depressed female patients underwent significantly fewer antidepressant drug 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 ₍₂₈₎=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). This is a retrospective pilot study whose results are based on subjective evaluations. 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.