Electroconvulsive therapy is associated with superior symptomatic and functional change in depressed patients after psychiatric hospitalization

Background: Major depressive episode is associated with quality of life (QO L) deficits, and QOL improves following remission of depression. We conduct ed an observational study of the relationship between depressive symptoms a nd QOL for 1 year after psychiatric hospitalization, and compared QOL in pa tients who received ECT against those who did not. Methods: We examined 88 patients with major depressive disorder (53.4 +/- 15.4 years old; 69 women) upon admission, with repeated measurements at discharge, 1, 3, 6, and 12 m onths after discharge. Depression severity was measured with the Beck Depre ssion Inventory. QOL measurements encompassed ADLs, IADLs, performance in m ajor roles, and satisfaction with relationships. Treatment for depression w as at the discretion of the respective physicians. Results: Depression seve rity dropped dramatically by discharge, and changed little thereafter. QOL measures showed improvement at the first month, with additional improvement at the third month. Improvement in QOL was closely tied to improvement in depression severity. ECT during the index hospitalization was associated wi th greater improvement in depressive symptoms and in most measures of QOL. Limitations: The results of this study may not apply to the treatment of ou tpatients, and the large number of statistical comparisons may have resulte d in some spurious associations. Conclusions: Inpatient treatment of depres sion is followed by improvement in QOL, Novel findings in this study includ e evidence that maximum improvement in QOL does not occur until an average of 3 months after discharge, and that ECT-treated patients had superior out comes. (C) 2001 Elsevier Science B.V. All rights reserved.