title: 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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Clinical Neuroscience Branch, National Institute of Mental Health, Bethesda, Md 20892, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Philibert
authors.forename: L
authors.initials: L
authors.lastname: Richards
authors.forename: C F
authors.initials: CF
authors.lastname: Lynch
authors.forename: G
authors.initials: G
authors.lastname: Winokur
mesh_terms: D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents