5-Year Follow UP After ECT For LLD: New Data From the MODECT Study

Out on PubMed, from researchers in the Low Countries, is this paper :

Long-term Outcome Following Electroconvulsive Therapy for Late-Life Depression: Five-Year Follow-up Data From the MODECT Study.

Lambrichts S, Wagenmakers MJ, Vansteelandt K, Obbels J, Schouws SNTM, Verwijk E, van Exel E, Bouckaert F, Vandenbulcke M, Schrijvers D, Veltman DJ, Beekman ATF, Oudega ML, Sienaert P, Dols A.Am J Geriatr Psychiatry. 2022 May 18:S1064-7481(22)00417-1. doi: 10.1016/j.jagp.2022.05.010. Online ahead of print.PMID: 35667960

The abstract is copied below:

Objective: Electroconvulsive therapy (ECT) is the most effective treatment for late-life depression (LLD). Research addressing long-term outcome following an acute course of ECT for LLD is limited. We aimed to describe relapse, cognitive impairment and survival 5 years after a treatment with ECT for severe LLD, and assess the association of clinical characteristics with all three outcome measures.

Methods: This cohort study was part of the Mood Disorders in Elderly treated with ECT (MODECT) study, which included patients aged 55 years and older with major depressive disorder. Data regarding clinical course, cognitive impairment and mortality were collected 5 years after the index ECT course. We used multivariable Cox proportional hazards models and logistic regression models to assess the association of clinical characteristics with relapse and survival, and cognitive impairment, respectively.

Results: We studied 110 patients with a mean age of 72.9 years. 67.1% of patients who showed response at the end of the index ECT course relapsed, and the included clinical characteristics were not significantly associated with the risk of relapse. 38.8% of patients with available data showed cognitive impairment at five-year follow-up. 27.5% were deceased; higher age and a higher number of previous psychiatric admissions were significantly associated with increased risk of mortality.

Conclusions: Five-year outcome after a course of ECT for severe LLD seems to be in line with long-term outcome following other acute treatments for severe LLD in terms of relapse, cognitive impairment and survival. Additional studies aimed at improving long-term outcome in severe LLD are warranted.

Keywords: Late-life depression; cognitive impairment; electroconvulsive therapy; relapse; survival.

And from the text:

This is an important long-term follow up study for the field. The cognitive data are particularly interesting.The take home messages are that depression is a very serious, chronic/recurrent illness and relapse prevention treatments/strategies need to be comprehensive and aggressive.

I recommend a full read of this study to all ECT practitioners, ~20 minutes.