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Related Experiment Videos

Successful ECT in long-term care residents.

M H Zisselman1, K G Kelly, T Cutillo-Schmitter

  • 1Temple University Department of Psychiatry, Temple Continuing Care Center, Philadelphia, PA 19141, USA.

Journal of the American Medical Directors Association
|June 19, 2003
PubMed
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Electroconvulsive therapy (ECT) is a safe and effective treatment for major depression in long-term care (LTC) residents, even those with medical comorbidities. Most patients showed improvement after ECT, highlighting its utility when medications fail.

Area of Science:

  • Geriatric Psychiatry
  • Neuroscience
  • Clinical Medicine

Background:

  • Depression is highly prevalent in long-term care (LTC) residents, contributing to increased mortality and morbidity.
  • Treatment resistance or intolerance to antidepressants is common in this population.
  • Electroconvulsive therapy (ECT) is a known effective treatment for older adults but is understudied in LTC settings.

Purpose of the Study:

  • To evaluate the safety and efficacy of Electroconvulsive therapy (ECT) in long-term care (LTC) residents.
  • To assess treatment outcomes and complications of ECT in a medically comorbid LTC population.

Main Methods:

  • Retrospective chart review of LTC residents who underwent ECT at an academic facility over three years.
  • Data collected included demographics, medical comorbidity (Cumulative Illness Rating Scale for Geriatrics - CIRS-G), psychiatric diagnosis, prior medication trials, and cognitive function (Mini-Mental State Examination - MMSE).

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  • ECT treatment details (number, stimuli type) and outcomes (Clinical Global Impression of Change - CGI) were analyzed.

    • Main Results:

    • Thirteen LTC residents (mean age 81) with major depression, often with psychotic features, received ECT.
    • All patients had significant medical comorbidities (mean CIRS-G 19.7) and had failed multiple psychotropic medications.
    • 69% of patients showed clinical improvement (CGI), with transient complications like cognitive decline, headache, or delirium, all fully reversible.

    Conclusions:

    • Electroconvulsive therapy (ECT) is a safe and effective treatment for major depression in medically complex long-term care residents.
    • ECT offers a viable therapeutic option for treatment-resistant depression in this vulnerable population.
    • Close monitoring for delirium is crucial during and after ECT in LTC residents to manage potential confusion.