Factors causing a relapse of major depressive disorders following successful electroconvulsive therapy: A retrospective cohort study

Figure 2 Changes in the treatment and diagnosis based on the relapse and manic/hypomanic episodes after remission after the first electroconvulsive therapy. Relapses were characterized by five or more of the diagnostic criteria for major depressive disorder. Patients in groups A and B did not experience relapse after the first course of electroconvulsive therapy (ECT). Patients in groups C and D experienced a relapse after the first course of ECT. When there was a manic/hypomanic episode during the follow-up, the diagnosis was changed from major depressive disorder to bipolar disorder. ECT: Electroconvulsive therapy; MDD: Major depressive disorder; BP: Bipolar disorder; Li: Lithium; ARP: Aripiprazole.