Effect of ECT on mortality and clinical outcome in geriatric unipolar depression.

Abstract

BACKGROUND: Recent reports have called into question the safety and effectiveness of electroconvulsive therapy (ECT). METHOD: To investigate these claims, the effects of ECT on clinical outcomes were examined as part of a retrospective, naturalistic study of 192 geriatric patients consecutively admitted between 1980 and 1987 to a large midwestern tertiary care center for the treatment of depression. Data were analyzed by a variety of parametric and nonparametric methods including ANOVA and survival analysis. RESULTS: Patients who received ECT (N = 108) were more likely to exhibit psychomotor retardation and to have had prior courses of ECT than those who did not receive ECT (N = 84). Furthermore, despite the absence of differences in the overall rate or severity of medical comorbidity, patients receiving ECT were more likely to be alive at follow-up and to demonstrate greater clinical improvement than those treated only with pharmacotherapy. CONCLUSION: These results confirm previous studies demonstrating the superior efficacy of ECT as compared with conventional pharmacotherapy treatment in patients hospitalized with depression and document its safety in long-term follow-up.