Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients

William Vaughn McCall, Sarah H. Lisanby, Peter B. Rosenquist, Mary Dooley, Mustafa M. Husain, Rebecca G. Knapp, Georgios Petrides, Matthew V. Rudorfer, Robert C. Young, Shawn M. McClintock, Martina Mueller, Joan Prudic, Robert M. Greenberg, Richard D. Weiner, Samuel H. Bailine, Mary Anne Riley, Laryssa McCloud, Charles H. Kellner

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Introduction Patients with Major Depressive Disorder (MDD) referred for electroconvulsive therapy (ECT) have poorer Health Related Quality of Life (HRQOL), compared with other patients with MDD, but ECT is associated with significant and durable improvement in HRQOL. However, no prior research has focused exclusively on elderly patients with MDD receiving ECT. Methods HRQOL data from 240 depressed patients over the age of 60 was measured with the Medical Outcomes Study Short Form 36 (SF-36). The SF-36 was measured before and after a course of acute ECT. Predictors of change in HRQOL scores were identified by generalized linear modeling. Results At baseline, participants showed very poor HRQOL. After treatment with ECT, the full sample showed marked and significant improvement across all SF-36 measures, with the largest gains seen in dimensions of mental health. Across all participants, the Physical Component Summary (PCS) score improved by 2.1 standardized points (95% CI, 0.61,3.56), while the Mental Component Summary (MCS) score improved by 12.5 points (95% CI, 7.2,10.8) Compared with non-remitters, remitters showed a trend toward greater improvement in the PCS summary score of 2.7 points (95%CI, −0.45, 5.9), while the improvement in the MCS summary score was significantly greater (8.5 points, 95% CI, 4.6,12.3) in the remitters than non-remitters. Post-ECT SF-36 measurements were consistently and positively related to baseline scores and remitter/non-remitter status or change in depression severity from baseline. Objective measures of cognitive function had no significant relationships to changes in SF-36 scores. Limitations This study's limitations include that it was an open label study with no comparison group, and generalizability is limited to elderly patients. Discussion ECT providers and elderly patients with MDD treated with ECT can be confident that ECT will result in improved HRQOL in the short-term. Attaining remission is a key factor in the improvement of HRQOL. Acute changes in select cognitive functions were outweighed by improvement in depressive symptoms in determining the short term HRQOL of the participants treated with ECT.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalJournal of Affective Disorders
Volume209
DOIs
StatePublished - Feb 1 2017

Keywords

  • ECT
  • Elderly
  • Major depressive disorder
  • Quality of life

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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    McCall, W. V., Lisanby, S. H., Rosenquist, P. B., Dooley, M., Husain, M. M., Knapp, R. G., Petrides, G., Rudorfer, M. V., Young, R. C., McClintock, S. M., Mueller, M., Prudic, J., Greenberg, R. M., Weiner, R. D., Bailine, S. H., Riley, M. A., McCloud, L., & Kellner, C. H. (2017). Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients. Journal of Affective Disorders, 209, 39-45. https://doi.org/10.1016/j.jad.2016.11.003