Quality of life outcomes of ECT

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Electroconvulsive therapy (ECT) continues to stand the test of time. There is a growing demand for patient reported outcome data including measures of HRQL, patient satisfaction and utility. ECT is efficacious for a number of psychiatric conditions but it is often reserved for the most ill patients because compared to drugs or psychotherapy it has a higher cost per unit of treatment, requires anesthesia, and because of a continuing stigma. As well, ECT has a particular set of side effects including the potential for memory impairment, and cardiac death. Mental illness produces profound deficits in HRQL and loss of HRQL is linear to severity of illness, and may therefore be part of decision to refer for ECT. At baseline studies have shown that ECT patients have reduced HRQL and functioning. ECT treatment improves HRQL and functioning in a lasting way for patients with major depression and schizophrenia. HRQL improvements are related to ECT’s effect on mood whereas functional improvements are more closely related to cognition