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One-year outcome of elderly inpatients with major depressive disorder treated with ECT and antidepressants

Martti Huuhka1, Lea Korpisammal, Riina Haataja

  • 1Department of Psychogeriatrics, Tampere University Hospital, Fin-33380 Pitkäniemi, Finland. martti.huuhka@pshp.fi

The Journal of ECT
|September 3, 2004
PubMed

Insights

Electroconvulsive therapy (ECT) and antidepressant therapy show good acute response in elderly patients with major depressive disorder. However, a high rehospitalization rate highlights the need for close follow-up after treatment.

Area of Science:

  • Geriatric Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Major depressive disorder (MDD) significantly impacts elderly individuals.
  • Effective acute treatments are crucial for this demographic.
  • Long-term outcomes and relapse rates require further investigation.

Purpose of the Study:

  • To evaluate the acute response and 1-year outcomes of electroconvulsive therapy (ECT) and antidepressant therapy in elderly inpatients with MDD.
  • To compare the efficacy and rehospitalization rates between ECT and antidepressant therapy.
  • To identify the need for continued monitoring in elderly patients post-depression recovery.

Main Methods:

  • A cohort of 51 elderly inpatients diagnosed with MDD were treated with either ECT (n=30) or antidepressant therapy (n=21).
  • Patients were assessed at admission, discharge, and 1-year follow-up using standardized scales: Montgomery and Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI).
  • Rehospitalization rates were tracked for the entire group and within each treatment arm over the 1-year period.

Main Results:

  • Both ECT and antidepressant therapy demonstrated a significant acute therapeutic response, with substantial reductions in MADRS scores during hospitalization.
  • The 1-year rehospitalization rate was considerable for the entire cohort (41%), with similar rates for ECT (43%) and antidepressant therapy (38%).
  • A notable proportion of patients, particularly in the ECT group, were rehospitalized within the first month post-discharge.

Conclusions:

  • Elderly patients with MDD exhibit a good acute response to both ECT and antidepressant therapy.
  • The study highlights a significant challenge in maintaining remission, evidenced by a high 1-year rehospitalization rate.
  • There is a critical need for robust and consistent follow-up care for elderly individuals recovering from depressive episodes to mitigate relapse and rehospitalization.

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