title: Benefits of Returning to Work After ECT.
abstract: BACKGROUND
  Severe unipolar or bipolar depression is often not helped by pharmacotherapy and/or psychotherapeutic treatment alone, whereas more than 80% of these patients remit after sessions of electroconvulsive treatment (ECT). Getting patients back to work after a severe depression may be important for maintaining the effect of ECT.
  
  
  METHODS
  Twenty consecutive patients remitted to an acute psychiatric hospital for depression underwent ECT. None of the patients had been working before the inpatient stay. Four patients were living on a permanent sickness allowance from the State (invalidity pension) before ECT, and thus were not expected to start work thereafter.
  
  
  RESULTS
  Ten of the patients returned to work. Hospital treatment in Norway (including ECT) is provided free of charge with no copayments from the patient. The mean length of sick leave before ECT was 14.7 months. The 10 patients who returned to work had accrued public costs before their inpatient stays totalling NOK (Norwegian krone) 2,994,635 or a mean of NOK 299,463 per patient (&OV0556;1 = 9 NOK or $1 = 6 NOK ). The total public cost of their inpatient stays was NOK 1,680,000. During the first year after ECT, these 10 patients received NOK 2,680,000 in wages (NOK 3,238,300 during the mean number of months they were observed).
  
  
  CONCLUSIONS
  Most of the patients (10 of 16) receiving ECT returned to work and within 2 years had earned more than the total cost both of their sick leave before admittance to hospital and the public cost of their 4 weeks' inpatient treatment. It is a pity that many countries, including Norway, only allow ECT as a treatment of last resort after failed psychotherapy or pharmacotherapy. Higher public spending is an inadvertent result of such a policy toward ECT.
authors: Oslo and Akershus University College, Oslo, Norway. johnerikberg@gmail.com
authors: John Erik
authors: JE
authors: Berg
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000191:economics / Q000523:psychology / Q000628:therapy; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003866:Depressive Disorder / Q000191:economics* / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000191:economics / Q000523:psychology / Q000628:therapy; D006233:Persons with Disabilities; D004565:Electroconvulsive Therapy / Q000191:economics*; D004651:Employment; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D009664:Norway; D010415:Pensions; D011618:Psychotic Disorders / Q000191:economics / Q000523:psychology / Q000628:therapy; D018582:Sick Leave / Q000706:statistics & numerical data; D055815:Young Adult