title: Health Related Quality of Life after ECT for depression: A study exploring the role of different electrode-placements and pulse-widths.
abstract: Prior research has shown large improvements in HRQOL after a course of ECT for depression. However, the effect of different types of ECT on HRQOL outcomes has not been explored. This is important due to the considerable range of ECT treatment modalities that currently exist in clinical practice.
  
  
  
  HRQOL data from 355 depressed patients in three Australian clinical hospitals, who received ECT given with a range of treatment modalities (combinations of pulse-width and electrode-placement), were analysed. HRQOL was measured at baseline and after ECT, using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). The association between type of ECT and HRQOL after ECT was examined by regression analysis, controlling for variables that may affect HRQOL outcomes.
  
  
  
  There was a significant increase in HRQOL scores after ECT (p<0.0001; t=-23.4). The magnitude of change was large (54% increase, Cohen's d=1.43). Multiple regression analysis yielded a significant model (P<0.001, R2=0.18). Baseline HRQOL score (t=4.83; p<0.0001), age (t=2.75, p<0.01) and type of ECT received [Right Unilateral brief vs Bitemporal Ultrabrief (t=-2.99; p<0.01) and Right Unilateral brief vs Bifrontal Ultrabrief (t=-2.70; p<0.01)] were significant predictors of HRQOL after the ECT course.
  
  
  
  Data was collected naturalistically from clinical services, thus ECT modality was not randomly assigned. Site could have confounded results.
  
  
  
  An acute course of ECT for depression produced statistically and clinically significant improvements in HRQOL. ECT treatment modality can substantially impact HRQOL outcomes, with the possibility of bilateral ultrabrief forms of ECT being less beneficial.
authors.affiliation: School of Psychiatry, University of New South Wales (UNSW), Randwick, Sydney, NSW, Australia; Black Dog Institute, Randwick, Sydney, NSW, Australia.
authors.forename: Verònica
authors.initials: V
authors.lastname: Gálvez
authors.affiliation: School of Psychiatry, University of New South Wales (UNSW), Randwick, Sydney, NSW, Australia; Black Dog Institute, Randwick, Sydney, NSW, Australia.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Li
authors.affiliation: School of Psychiatry, University of New South Wales (UNSW), Randwick, Sydney, NSW, Australia; Black Dog Institute, Randwick, Sydney, NSW, Australia; Institute of Psychiatry, King's College London, London, UK.
authors.forename: Cristal
authors.initials: C
authors.lastname: Oxley
authors.affiliation: The Queen Elizabeth Hospital, Woodville South, SA, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Waite
authors.affiliation: Perth Clinic, West Perth, WA, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: De Felice
authors.affiliation: School of Psychiatry, University of New South Wales (UNSW), Randwick, Sydney, NSW, Australia; Black Dog Institute, Randwick, Sydney, NSW, Australia.
authors.forename: Dusan
authors.initials: D
authors.lastname: Hadzi-Pavlovic
authors.affiliation: School of Psychiatry, University of New South Wales (UNSW), Randwick, Sydney, NSW, Australia; Black Dog Institute, Randwick, Sydney, NSW, Australia.
authors.forename: Divya
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Perth Clinic, West Perth, WA, Australia; School of Psychology, The University of Western Australia, Crawley, WA, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Page
authors.affiliation: Perth Clinic, West Perth, WA, Australia.
authors.forename: Geoff
authors.initials: G
authors.lastname: Hooke
authors.affiliation: School of Psychiatry, University of New South Wales (UNSW), Randwick, Sydney, NSW, Australia; Black Dog Institute, Randwick, Sydney, NSW, Australia; Department of Psychiatry, St George Hospital, Kogarah, NSW, Australia. Electronic address: colleen.loo@unsw.edu.au.
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Loo
mesh_terms: D000328:Adult; D001315:Australia; D003863:Depression / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011674:Pulse; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome
keywords: Electroconvulsive Therapy (ECT); Electrode placement; Health-Related-Quality of Life (HRQOL); Pulse-width