Among the three new articles on Pubmed today is this excellent Swedish study of ECT's effect on quality of life:
Electroconvulsive Therapy in Depression: Improvement in Quality of Life Depending on Age and Sex
JECT 2020 Feb 27 [Online ahead of print]
- PMID: 32108666
The pdf is here
This is a register-basd cohort study with 1066 patients from the Swedish National Quality Register for ECT. The authors found significant increases in health-related quality of life after ECT across the board, but the improvement was greater in elderly patients, who also more often had psychotic features. This is consistent with the (intuitive) finding that more severely ill patients have the greatest improvement with ECT.
This is an excellent study and the paper is well written; I think it deserves a careful read. It is another example of the benefit of having population data sets from countries with socialized medical systems.
Thank you for mentioning the study in the blog. All treatments have side effect, and those of ECT are frequently discussed. This study points to what every ECT doctor already knows: in a large majority of patients, patients find that the benefits outweigh the side effects by far. I hope it will be useful in some discussions in the future. The improvement was greater in old patients as compared to young patients. More prevalent psychotic features among old patients is one explanation. We hope to further explain these differential effects in future studies.
ReplyDeleteAxel Nordenskjöld, Registrar, The Swedish national quality register for ECT
The detractors of ECT would want you to believe that life after ECT is worse, not better. Yet this study by Guney et al. once again clearly shows that quality of life (QOL) improves after treatment of depression with ECT. While all ages and genders experienced improvement in QOL, the improvement was greatest in older depressed patients, and is consistent with everything we know about superior antidepressant efficacy of ECT in older patients. Data from Guney et al, and other similar work, should encourage psychiatrists to consider ECT early in the treatment algorithm for severe depression, especially for older patients.
ReplyDelete- Vaughn McCall
Great to have these experts commenting, thanks much!
ReplyDelete