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A Prospective Naturalistic Study of Electroconvulsive Therapy in Late-Life Depression

Geriatric Health Services Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA

Jules Rosen, MD

Geriatric Health Services Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA

Joe E. Thornton, MD

Geriatric Psychiatry Service James Hanley Veterans Hospital and University of South Florida, Tampa, FL

George S. Zubenko, MD, PhD

Geriatric Health Services Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA

We performed a prospective, naturalistic study using standardized clinical rating scales to characterize the effect of electroconvulsive therapy (ECT) on mood, cognition, and medical status in late-life depression. Over a 16-month period, 40 patients aged 60 years and over who fulfilled DSM-III criteria for a major depressive episode received a total of 42 ECT courses. Three patients (7%) developed significant medical complications: one had a syncopal episode due to arrhythmia, and two had symptomatic vertebral compression fractures. Confusion was noted during 13 courses (31%) and persisted at discharge in four (10%). More than half the patients were either psychotic or demented on admission, and all but three had been either unresponsive or intolerant to pharmacotherapy. All patients experienced a decrease in their depressive symptoms and more than two thirds were in complete or partial remission at discharge. Patients with psychotic depression experienced a greater improvement than patients with nonpsychotic depression, and patients with organic mental disorders experienced the same improvement as other patients. This study confirms that ECT is a safe and effective treatment of depression in late life. (J Geriatr Psychiatry Neurol 1991; 4:3-13).

Journal of Geriatric Psychiatry and Neurology, Vol. 4, No. 1, 3-12 (1991)
DOI: 10.1177/089198879100400102


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