By Ashwin, UK Correspondent, [RxPG] Electroconvulsive therapy (ECT) improves quality of life and functioning in people with severe depression, a new study has found.
For many years ECT has been seen as a highly controversial therapy for major depression. The National Institute for Clinical Excellence (NICE) has recommended limiting its use, partly because of the inadequacy of research into the effects of ECT on quality of life and individual function.
This prospective study from the USA, published in the November issue of the British Journal of Psychiatry, set out to examine the effects of ECT on function and quality of life, particularly as they relate to changes in mood and cognition in the month following this therapy.
77 depressed patients aged over 18, with no history of schizophrenia, schizoaffective disorder, active substance misuse, learning disability or neurological disorder were recruited. No patient had received ECT during the previous four months.
Participants received treatment with antidepressant medication during the month-long period of observation after ECT treatment. Depression severity and cognition were assessed 1-3 days before ECT, immediately afterwards, and at two and four weeks after ECT.
66% of the participants were found to respond positively to ECT. They showed improvement in every measure of mood, most measures of cognition, quality of life and function both at two and four weeks after ECT treatment. Further, the majority of the changes measured were statistically significant.
The authors of the study comment that change in perceived quality of life seemed to be most influenced by changes in mood, whereas change in function was related to change in cognition.
The results of this study support that premise that ECT produces a net improvement in health for most patients. A restrictive attitude towards ECT is not warranted on the basis of its effects on quality of life and function.
Reference: McCall WV, Dunn A and Rosenquist PB (2004) Quality of life and function after electroconvulsive therapy. British Journal of Psychiatry, 185, 405-409.
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