Treatment-Resistant Mood Disorders in LGBTQ People: A Retrospective Study of Clinical Features and Response to Electroconvulsive Therapy

Instructions

Click the REGISTER button to take the posttest
Click here to return to the JCP CME article 

Overview

In this chart review, LGBTQ people with treatment-resistant mood disorders had clinical features linked to worse outcomes, but their improvement with ECT was similar to that seen in non-LGBTQ patients.


Read the whole article at psychiatrist.com here: 
Treatment-Resistant Mood Disorders in LGBTQ People: A Retrospective Study of Clinical Features and Response to Electroconvulsive Therapy 

© Copyright 2022 Physicians Postgraduate Press, Inc.

Target Audience

Psychiatrists

Learning Objectives

Identify clinical features of LGBTQ people who have a severe or treatment-resistant mood disorder, including risk factors, treatment needs, and predictors of treatment response to make appropriate treatment decisions for these patients.

Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
07/22/2022
Activity expires: 
08/31/2023
Cost:
$0.00

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.

CME Objective

After studying this article, you should be able to:

  • Identify clinical features of LGBTQ people who have a severe or treatment-resistant mood disorder, including risk factors, treatment needs, and predictors of treatment response to make appropriate treatment decisions for these patients.

Statement of Need and Purpose

Among individuals who identify as lesbian, gay, or bisexual people, suicide attempt has been reported to be twice as common and depression, anxiety, and substance abuse at least 1.5 times more common, and transgender people have been shown to have higher risk of suicidality, interpersonal trauma, and substance use disorders. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Major Depressive Disorder (MDD) states that electroconvulsive therapy (ECT) should be considered as a treatment option for all patients with MDD who have high symptom severity or an urgent need for response, such as patients who are suicidal. However, borderline personality disorder and posttraumatic stress disorder are thought to predict less favorable ECT outcomes and are more prevalent in LGBTQ people. LGBTQ patients are known to experience greater barriers to health care access in general, and little is known about the clinical features of LGBTQ people who have severe or treatment-resistant mood disorders. Clinicians need education on the features associated with treatment-resistant depression in LGBTQ patients and to be able to identify any risk factors and treatment needs that may be specific to this population including predictors of treatment response to assist them in making the most effective and appropriate treatment decisions for these patients.

Release, Expiration, and Review Dates

This educational activity was published in July 2022 and is eligible for AMA PRA Category 1 Credit™ through August 31, 2023. The latest review of this material was July 2022.

Disclosure of Off-Label Usage

Dr Mickey has determined that, to the best of his knowledge, electroconvulsive therapy is not approved by the US Food and Drug Administration for the treatment of schizoaffective disorder, schizophrenia, manic episodes, or mixed episodes.

Funding/Support

No direct funding was received for this research.

Previous presentation

Some of this work was previously reported as a poster at the 2021 Virtual Meeting of the Society of Biological Psychiatry, April 29–May 1, 2021; the 30th annual Virtual Meeting of the International Society of ECT and Neurostimulation, April 24–25, 2021; and the 117th Annual Meeting of the Japanese Society of Psychiatry and Neurology, September 19–21, 2021, Kyoto, Japan.

Faculty Affiliation

Fumie Oka
Department of Psychiatry and Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah 
Corresponding author: Fumie Oka, MD, or Brian J. Mickey, MD, 501 Chipeta Way, Salt Lake City, UT 84108 ([email protected]; [email protected]).

Kamile Weischedel
Department of Psychiatry and Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah 

Amanda Bakian
Department of Psychiatry and Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah 

Brian J. Mickey
Department of Psychiatry and Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah 

Financial Disclosure 

All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past 3 years, Marlene P. Freeman, MD, Editor in Chief, has received research funding from JayMac and Sage; has been a member of the Independent Data Safety and Monitoring Committee for Janssen (Johnson & Johnson), Novartis, and Neurocrine; and has served on advisory boards for Eliem and Sage. As an employee of Massachusetts General Hospital (MGH), Dr Freeman works with the MGH National Pregnancy Registry, which receives funding from Alkermes, Aurobindo, AuroMedics, Johnson & Johnson/Janssen, Otsuka, Sage, Sunovion, Supernus, and Teva, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. Dr Freeman has also received royalties through MGH for the Massachusetts General Hospital Female Reproductive Lifecycle and Hormones Questionnaire. No member of the CME Institute staff reported any relevant personal financial relationships

All authors report no conflicts of interest related to this work.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation

Price

Cost:
$0.00
Please login or register to take this activity.

Register for free on our site to participate in this and many free CME courses.