Continuation of ECT Improves Quality of Life in Depressed Elderly
At 24 weeks, the mean SF-36 physical component score and mental component score were significantly higher in the electroconvulsive therapy group compared with the drugs-only group.
According to findings published in the Journal of Psychiatric Research, elderly patients who responded to acute electroconvulsive therapy had improved quality of life after continuation of electroconvulsive therapy compared with participants who continued with medication alone.
To evaluate the long-term outcomes of electroconvulsive therapy on health-related quality of life for patients with major depressive disorder, 120 elderly patients (mean age 70.5 years) from a previous randomized controlled trial who remitted to the acute course of electroconvulsive therapy were enrolled in this study. Participants were randomly assigned to continue venlafaxine and lithium or to continue these same medications plus 4 weekly outpatient electroconvulsive therapy sessions.
Patients with comorbid dementia, schizophrenia, bipolar disorder, or substance use disorder were excluded. Depressive symptoms, cognitive function, and health-related quality of life (Medical Outcomes Study Short Form 36 [SF-36]) were measured throughout the study.
Participants in the electroconvulsive therapy group received a mean of 4.5 (SD 2.5) electroconvulsive therapy sessions.
At 24 weeks, the mean SF-36 physical component score and mental component score were significantly higher in the electroconvulsive therapy group compared with the drugs-only group after adjustment for time and group (P <.001). Similarly, the scores were significantly higher in the electroconvulsive therapy group for all subcategories (all P <.02) except the bodily pain subcategory (P =.08).
After multivariate adjustment, SF-36 subcategories were significantly higher in the electroconvulsive therapy group compared with the drugs-only group at 24 weeks (all P <.04), with the exception of the social functioning, role emotional, and role physical subcategories.
The study authors concluded that the results, “should assure patients, families, and caregivers of depressed elderly patients that [electroconvulsive therapy] is a medically appropriate choice for elderly adults with [major depressive disorder] and is likely to produce improvement in [health-related quality of life] that can be sustained during the continuation phase of treatment by employing combined [electroconvulsive therapy] and medication to support remission.”
McCall WV, Lisanby SH, Rosenquist PB, et al. Effects of continuation electroconvulsive therapy on quality of life in elderly depressed patients: a randomized clinical trial. J Psychiatr Res. 2017;97:65-69.