title: Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients.
abstract: Patients with Major Depressive Disorder (MDD) referred for electroconvulsive therapy (ECT) have poorer Health Related Quality of Life (HRQOL), compared with other patients with MDD, but ECT is associated with significant and durable improvement in HRQOL. However, no prior research has focused exclusively on elderly patients with MDD receiving ECT.
  
  
  
  HRQOL data from 240 depressed patients over the age of 60 was measured with the Medical Outcomes Study Short Form 36 (SF-36). The SF-36 was measured before and after a course of acute ECT. Predictors of change in HRQOL scores were identified by generalized linear modeling.
  
  
  
  At baseline, participants showed very poor HRQOL. After treatment with ECT, the full sample showed marked and significant improvement across all SF-36 measures, with the largest gains seen in dimensions of mental health. Across all participants, the Physical Component Summary (PCS) score improved by 2.1 standardized points (95% CI, 0.61,3.56), while the Mental Component Summary (MCS) score improved by 12.5 points (95% CI, 7.2,10.8) Compared with non-remitters, remitters showed a trend toward greater improvement in the PCS summary score of 2.7 points (95%CI, -0.45, 5.9), while the improvement in the MCS summary score was significantly greater (8.5 points, 95% CI, 4.6,12.3) in the remitters than non-remitters. Post-ECT SF-36 measurements were consistently and positively related to baseline scores and remitter/non-remitter status or change in depression severity from baseline. Objective measures of cognitive function had no significant relationships to changes in SF-36 scores.
  
  
  
  This study's limitations include that it was an open label study with no comparison group, and generalizability is limited to elderly patients.
  
  
  
  ECT providers and elderly patients with MDD treated with ECT can be confident that ECT will result in improved HRQOL in the short-term. Attaining remission is a key factor in the improvement of HRQOL. Acute changes in select cognitive functions were outweighed by improvement in depressive symptoms in determining the short term HRQOL of the participants treated with ECT.
authors.affiliation: Augusta University/Medical College of Georgia, Georgia, USA. Electronic address: wmccall@augusta.edu.
authors.forename: W Vaughn
authors.initials: WV
authors.lastname: McCall
authors.affiliation: National Institute of Mental Health, Bethesda, Maryland, USA.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Lisanby
authors.affiliation: Augusta University/Medical College of Georgia, Georgia, USA.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Rosenquist
authors.affiliation: Medical University of South Carolina, Charleston, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Dooley
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, USA.
authors.forename: Mustafa M
authors.initials: MM
authors.lastname: Husain
authors.affiliation: Medical University of South Carolina, Charleston, USA.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Knapp
authors.affiliation: Zucker Hillside Hospital/North Shore-LIJ Health System, New York, USA.
authors.forename: Georgios
authors.initials: G
authors.lastname: Petrides
authors.affiliation: National Institute of Mental Health, Bethesda, Maryland, USA.
authors.forename: Matthew V
authors.initials: MV
authors.lastname: Rudorfer
authors.affiliation: New York Presbyterian/Weill Cornell Medical Center, New York, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Young
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, USA.
authors.forename: Shawn M
authors.initials: SM
authors.lastname: McClintock
authors.affiliation: Medical University of South Carolina, Charleston, USA.
authors.forename: Martina
authors.initials: M
authors.lastname: Mueller
authors.affiliation: New York Presbyterian/Weill Cornell Medical Center, New York, USA; Columbia University and New York State Psychiatric Institute, New York, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Prudic
authors.affiliation: NYU School of Medicine, New York, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Greenberg
authors.affiliation: Duke University School of Medicine, Durham, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Weiner
authors.affiliation: Zucker Hillside Hospital/North Shore-LIJ Health System, New York, USA.
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Bailine
authors.affiliation: Augusta University/Medical College of Georgia, Georgia, USA.
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Riley
authors.affiliation: Augusta University/Medical College of Georgia, Georgia, USA.
authors.forename: Laryssa
authors.initials: L
authors.lastname: McCloud
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Kellner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012074:Remission Induction; D016896:Treatment Outcome
keywords: ECT; Elderly; Major depressive disorder; Quality of life