TY - JOUR
T1 - Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients
AU - McCall, William Vaughn
AU - Lisanby, Sarah H.
AU - Rosenquist, Peter B.
AU - Dooley, Mary
AU - Husain, Mustafa M.
AU - Knapp, Rebecca G.
AU - Petrides, Georgios
AU - Rudorfer, Matthew V.
AU - Young, Robert C.
AU - McClintock, Shawn M.
AU - Mueller, Martina
AU - Prudic, Joan
AU - Greenberg, Robert M.
AU - Weiner, Richard D.
AU - Bailine, Samuel H.
AU - Riley, Mary Anne
AU - McCloud, Laryssa
AU - Kellner, Charles H.
N1 - Funding Information:
This work was supported by NIMH grant U01MH055495-09 (Mt Sinai); U01MH055495-09 , 1U01MH086127-01 (Wake Forest); 7U01MH086127 and 3U01MH086127-06S1 (Medical College of Georgia); U01MH081362 (Medical University of South Carolina); 5U01-MH086122 (Weill Cornell Medicine); 5U01MH84241-5 (Duke); 5U01MH086130 (Mayo); 5U01MH08612005 (UTSW); U01 MH084241 (Duke); U01-MH086123 (LIJ).
Funding Information:
Dr. McCall has been a scientific advisor for Merck, and Israeli Growth Partners, and a consultant to Luitpold Pharmaceuticals, Inc and Multiple Energy Technologies, LLC. Dr. Kellner receives honoraria from UpToDate, Psychiatric Times, and Northshore-LIJ Health System, and is a consultant to Luitpold Pharmaceuticals, Inc. Dr. Husain has received grant support from NIDA, NINDS, NIA, NARSD, Stanley Foundation, Cyberonics, Neuronetics, St. Jude medical (ANS), MagStim, Brainsway, NeoSync, Alkermes, and Corcept, and has been a consultant to Cerebain Inc. Dr. Young is a consultant to the NIH. Dr. Lisanby has received grant support from NINDS , NIBIB , Brain and Behavior Research Foundation , Stanley Medical Research Foundation , Neosync , Nexstim , and Brainsway . Dr. Petrides has received research support from Amgen , Astra Zeneca , Corcept , Eli Lilly , Proteus , St. Jude Medical , and Sunovion , and he has served on an advisory panel for Corcept. Dr. McClintock has received grant support from the NIH/NIMH and honoraria from TMS Health Solutions. The other authors report no financial relationships with commercial interests.
Publisher Copyright:
© 2016 Elsevier B.V.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - 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.
AB - 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.
KW - ECT
KW - Elderly
KW - Major depressive disorder
KW - Quality of life
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U2 - 10.1016/j.jad.2016.11.003
DO - 10.1016/j.jad.2016.11.003
M3 - Article
C2 - 27886569
AN - SCOPUS:84996605308
SN - 0165-0327
VL - 209
SP - 39
EP - 45
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -