title: Effect of Age on Psychiatric Rehospitalization Rates After Electroconvulsive Therapy for Patients With Depression.
abstract: OBJECTIVE
  The aims of this naturalistic study are to examine psychiatric rehospitalization rates in geriatric compared to nongeriatric patients who receive electroconvulsive therapy (ECT) and to characterize the sustained effectiveness of ECT for treatment of depression.
  
  
  METHODS
  Retrospective review of electronic medical records at a tertiary care center for patients with major depressive disorder who received an acute course of ECT at an index psychiatric hospitalization over a 5-year period. Data for subsequent psychiatric and primary care encounters were ascertained by chart review. Outcomes of interest included between-group differences in rates of psychiatric rehospitalization, time to rehospitalization, rates of other types of clinical follow-up care, and effect of demographic variables on clinical outcome.
  
  
  RESULTS
  Of 482 total patients, there were 210 (44%) geriatric patients (≥65 years). These patients experienced lower overall rates of psychiatric rehospitalization after ECT (6.2% vs 22%; P < 0.0001) compared to the nongeriatric group. Cox proportional hazard models indicated that older age, assessed both as a dichotomous and continuous variable, was associated with lower risk of rehospitalization. The majority (76.9%) of detected rehospitalizations among geriatric patients occurred within 6 months. In comparison, rates of outpatient primary care and psychiatric follow-up after ECT did not differ as a function of age.
  
  
  CONCLUSIONS
  Our findings suggest that geriatric patients with major depression receive greater long-term benefit from an acute course of ECT than do nongeriatric patients. Much more research is needed on this topic to rigorously evaluate the long-term efficacy of ECT in geriatric populations.
authors: From the *Department of Psychiatry, University of California San Francisco; †Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
authors: Brooke H
authors: BH
authors: Rosen
authors: Simon
authors: S
authors: Kung
authors: Maria I
authors: MI
authors: Lapid
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome