title: Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) is diminished in depressed adult outpatients and especially impaired among depressed patients referred for ECT. We compare pretreatment HRQOL in ECT and non-ECT depressed patients from two large samples, and examined whether sustained remission in depressive symptoms after ECT is associated with normalization of HRQOL.
  
  
  METHODS
  HRQOL was measured with the Medical Outcomes Study Short Form 36 (SF36) before ECT and 6 months after ECT in an effectiveness (n=286) and an efficacy (n=243) clinical trial.
  
  
  RESULTS
  ECT patients had very low baseline SF36 scores. With one exception, SF36 subscale scores in both trials were significantly lower than those of depressed outpatients. A minority of patients in both trials entered and sustained remission over the 24 week timeframe. Among sustained remitters, average SF36 scores were no different from normative scores of the general adult population, except that in the effectiveness study ECT patients reported less Bodily Pain (p<0.05) and better Mental Health (p<0.05), while in the efficacy study ECT patients reported more difficulty with Role-Emotional (p<0.01).
  
  
  CONCLUSIONS
  Only a modest number of patients were observed in sustained remission.
  
  
  CONCLUSIONS
  HRQOL is very poor in patients referred for ECT. Depressed patients who experience sustained remission after ECT, however, can expect improvement in their quality of life that leaves many in a position indistinguishable from the general adult population.
authors.affiliation: Department of Psychiatry and Health Behavior, Georgia Health Sciences University, Augusta, GA 30912, USA. wmccall@georgiahealth.edu
authors.forename: W Vaughn
authors.initials: WV
authors.lastname: McCall
authors.forename: David
authors.initials: D
authors.lastname: Reboussin
authors.forename: Joan
authors.initials: J
authors.lastname: Prudic
authors.forename: Roger F
authors.initials: RF
authors.lastname: Haskett
authors.forename: Keith
authors.initials: K
authors.lastname: Isenberg
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
authors.forename: Peter B
authors.initials: PB
authors.lastname: Rosenquist
authors.forename: Harold A
authors.initials: HA
authors.lastname: Sackeim
mesh_terms: D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012074:Remission Induction