title: Electroconvulsive therapy: a life course approach for recurrent depressive disorder.
abstract: We describe the case of an 89-year-old woman (deceased) with a 60-year history of recurrent depressive disorder treated with electroconvulsive therapy (ECT). It is estimated that she received up to 400 ECTs over her life course as her symptoms would not respond to oral medication. Despite extensive exposure to ECT, there was only minimal cognitive impairment and an excellent safety record, even in later life, as she became increasingly frail from multiple comorbidities. Over the years, there has been a drive to reduce the frequency of ECT administration. However, this case illustrates how in some patients ECT may be vital for acute episodes of severe depression as well as for maintenance therapy. This case report adds to observational evidence that maintenance ECT may be an underused treatment for recurrent depression and also recommends that greater emphasis be given to incorporating carers' views when planning individualised treatment approaches.
authors.affiliation: Kent and Medway NHS and Social Care Partnership Trust, Ashford, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Carney
authors.affiliation: Kent and Medway NHS and Social Care Partnership Trust, Canterbury, UK.
authors.forename: Musa Basseer
authors.initials: MB
authors.lastname: Sami
authors.affiliation: Kent and Medway NHS and Social Care Partnership Trust, Folkestone, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Clark
authors.affiliation: Kent and Medway NHS and Social Care Partnership Trust, Ramsgate, UK.
authors.forename: Kompancariel Kuruvilla
authors.initials: KK
authors.lastname: Kuruvilla
mesh_terms: D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000628:therapy*; D003937:Diagnosis, Differential; D004565:Electroconvulsive Therapy / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D012008:Recurrence; D016896:Treatment Outcome