The anatomy of excitement Understanding and improving the effectiveness of electroconvulsive therapy

Electroconvulsive therapy (ECT) is an effective treatment for severe depression. In this thesis, I studied electroconvulsive therapy (ECT) research with the objective to improve the clinical outcome after treatment and to gain a better understanding of its working mechanisms. Multiple methods in ECT research were explored, varying with respect to sample selection (i.e., single- versus multi-center data), study design (i.e., observational retrospective study versus prospective RCT, controlled versus non-controlled), type of data (i.e., clinical, EEG, and [f]MRI), and the applied statistical models to analyze the data (i.e., frequentist versus Bayesian models). Additionally, I proposed a taxonomy of ECT research. The main chapters can be considered as specific case-examples of the child-nodes of this taxonomy. Thereby, this thesis contributes to improving the clinical outcome and understanding of the working mechanisms of ECT. Based on the findings in this thesis, I have discussed the methods that are commonly used in ECT research and which future directions this may take.