Effect of Electroconvulsive Therapy on Health-Related Quality of Life in Older Depressed Patients

This is the authors' abstract. We don't add key points for this paper.

BACKGROUND: Research has shown large improvements in quality of life after a course of electroconvulsive therapy (ECT) for severe depressive disorder. The effect of ECT on health-related quality of life (HRQOL) in the Australian older population has not been explored. OBJECTIVES: This study aimed to investigate the impact of ECT on HRQOL in older patients with severe major depression and confirm that ECT in these participants is associated with an improvement in depression and no change in cognition. METHODS: Data on 34 patients from a Public Older Persons Mental Health Service in Queensland were collected. The Quality of Life Enjoyment and Satisfaction Questionnaire Short Form, Montgomery-Asberg Depression Rating Scale (MADRS), and Montreal Cognitive Assessment (MoCA) were used pre- and post-ECT. The Wilcoxon signed rank test, Friedman test, and Kendall τ correlation coefficient were performed. RESULTS: A significant improvement in Quality of Life Enjoyment and Satisfaction Questionnaire Short Form was demonstrated post-ECT. Montgomery-Asberg Depression Rating Scale scores decreased significantly post-ECT. Montreal Cognitive Assessment score increased significantly post-ECT. Significant results were sustained at the 3-month time point. CONCLUSIONS: An acute course of ECT for severe depressive disorder was associated with clinically and statistically significant improvement in HRQOL. There was also clinical and statistical improvement in depression and no significant decrease in global cognitive function, memory, or executive function domains after ECT compared with baseline. In fact, the cohort showed improvement on measures of cognition post-ECT.

ECT may support QoL gains in older severe depression; leaves open need for randomized confirmation before practice change.