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The presence of first-line indications for using ECT was significantly associated to shorter duration of MDE (9.1 vs 13.1 months, p less then 0.001) and lower number of lines of treatment before ECT (3.3 vs 4.1, p less then 0.001). LIMITATIONS This is a retrospective study and not all facilities practicing ECT participated that could limit the extrapolation of the results. CONCLUSION Compared to guidelines, ECT was not used as first-line strategy in clinical practice. The presence of first-line indications seemed to reduce the delay befor
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