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Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients.

Publication ,  Journal Article
McCall, WV; Lisanby, SH; Rosenquist, PB; Dooley, M; Husain, MM; Knapp, RG; Petrides, G; Rudorfer, MV; Young, RC; McClintock, SM; Mueller, M ...
Published in: J Affect Disord
February 2017

INTRODUCTION: 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. METHODS: 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. RESULTS: 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. LIMITATIONS: This study's limitations include that it was an open label study with no comparison group, and generalizability is limited to elderly patients. DISCUSSION: 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.

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Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

February 2017

Volume

209

Start / End Page

39 / 45

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Remission Induction
  • Quality of Life
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Humans
  • Health Status
 

Citation

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McCall, W. V., Lisanby, S. H., Rosenquist, P. B., Dooley, M., Husain, M. M., Knapp, R. G., … CORE/PRIDE Work Group. (2017). Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients. J Affect Disord, 209, 39–45. https://doi.org/10.1016/j.jad.2016.11.003
McCall, W Vaughn, Sarah H. Lisanby, Peter B. Rosenquist, Mary Dooley, Mustafa M. Husain, Rebecca G. Knapp, Georgios Petrides, et al. “Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients.J Affect Disord 209 (February 2017): 39–45. https://doi.org/10.1016/j.jad.2016.11.003.
McCall WV, Lisanby SH, Rosenquist PB, Dooley M, Husain MM, Knapp RG, et al. Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients. J Affect Disord. 2017 Feb;209:39–45.
McCall, W. Vaughn, et al. “Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients.J Affect Disord, vol. 209, Feb. 2017, pp. 39–45. Pubmed, doi:10.1016/j.jad.2016.11.003.
McCall WV, Lisanby SH, Rosenquist PB, Dooley M, Husain MM, Knapp RG, Petrides G, Rudorfer MV, Young RC, McClintock SM, Mueller M, Prudic J, Greenberg RM, Weiner RD, Bailine SH, Riley MA, McCloud L, Kellner CH, CORE/PRIDE Work Group. Effects of a right unilateral ultrabrief pulse electroconvulsive therapy course on health related quality of life in elderly depressed patients. J Affect Disord. 2017 Feb;209:39–45.
Journal cover image

Published In

J Affect Disord

DOI

EISSN

1573-2517

Publication Date

February 2017

Volume

209

Start / End Page

39 / 45

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Remission Induction
  • Quality of Life
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Humans
  • Health Status