Abstract
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
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Fink M. Electroshock: Restoring the Mind. New York: Oxford University Press; 1999
Pettinati HM, Tamburello TA, Ruetsch CR, et al. Patient attitudes toward electroconvulsive therapy. Psychopharmacol Bull 1994;30: 471–475
Dowman J, Patel A, Rajput K. Electroconvulsive therapy: attitudes and misconceptions. J ECT 2005;21: 84–87
Greenhalgh J, Knight C, Hind D, et al. Clinical and cost-effectiveness of electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania: systematic reviews and economic modelling studies. Health Technol Assess 2005;9: 1-iv
National Institute for Clinical Excellence. Technology Appraisal Guidance 59: Guidance on the use of electroconvulsive therapy. London: National Institute for Clinical Excellence; 2005:
Abrams R. Electroconvulsive Therapy. 3rd Edition ed. New York, NY: Oxford University Press; 1997
Pagnin D, de Q, V, Pini S, et al. Efficacy of ECT in depression: a meta-analytic review. J ECT 2004;20: 13–20
Chanpattana W, Chakrabhand ML, Sackeim HA, et al. Continuation ECT in treatment-resistant schizophrenia: a controlled study. J ECT 1999;15: 178–192
Sackeim HA, Decina P, Kanzler M, et al. Effects of electrode placement on the efficacy of titrated, low-dose ECT. Am J Psychiatry 1987;144: 1449–1455
Sackeim HA, Prudic J, Devanand DP, et al. Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. N Engl J Med 1993;328: 839–846
Sackeim HA, Prudic J, Devanand DP, et al. A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Arch Gen Psychiatry 2000;57: 425–434
Dombrovski AY, Mulsant BH, Haskett RF, et al. Predictors of remission after electroconvulsive therapy in unipolar major depression. J Clin Psychiatry 2005;66: 1043–1049
Rosenquist PB, McCall WV. Electroconvulsive Therapy. In: Aminoff M, Darroff R, eds. Encyclopedia of the Neurological Sciences. San Diego: Academic Press; 2003:
Rosenquist PB, Dunn A, Rapp S, et al. What predicts patients’ expressed likelihood of choosing electroconvulsive therapy as a future treatment option? J ECT 2006;22: 33–37
Wells KB, Stewart A, Hays RD, et al. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA 1989;262: 914–919
Goldney RD, Fisher LJ, Wilson DH, et al. Major depression and its associated morbidity and quality of life in a random, representative Australian community sample. Aust N Z J Psychiatry 2000;34: 1022–1029
Stewart AL, Sherbourne CD, Wells KB, et al. Do depressed patients in different treatment settings have different levels of well-being and functioning? J Consult Clin Psychol 1993;61: 849–857
McCall WV, Cohen W, Reboussin B, et al. Pretreatment differences in specific symptoms and quality of life among depressed inpatients who do and do not receive electroconvulsive therapy: a hypothesis regarding why the elderly are more likely to receive ECT. J ECT 1999;15: 193–201
Shmuely Y, Baumgarten M, Rovner B, et al. Predictors of improvement in health-related quality of life among elderly patients with depression. Int Psychogeriatr 2001;13: 63–73
Goldman HH, Skodol AE, Lave TR. Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 1992;149: 1148–1156
Narud K, Mykletun A, Dahl AA. Quality of life in patients with personality disorders seen at an ordinary psychiatric outpatient clinic. BMC Psychiatry 2005;5: 10
Reine G, Simeoni MC, Auquier P, et al. Assessing health-related quality of life in patients suffering from schizophrenia: a comparison of instruments. Eur Psychiatry 2005;20: 510–519
Heinrichs DW, Hanlon TE, Carpenter WT, Jr. The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984;10: 388–398
Brodaty H, Berle D, Hickie I, et al. Perceptions of outcome from electroconvulsive therapy by depressed patients and psychiatrists. Aust N Z J Psychiatry 2003;37: 196–199
Dew RE, Kimball JN, Rosenquist PB, et al. Seizure length and clinical outcomes in electroconvulsive therapy using methohexital or thiopental. 21 ed 2005: 16–18
Casey P, Meagher D, Butler E. Personality, functioning, and recovery from major depression. J Nerv Ment Dis 1996;184: 240–245
Remington M, Tyrer P. The Social Functioning Schedule: A brief semi-structured interview. 40 ed 1979: 151–157
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23: 56–62
Blazer DG. Severe episode of depression in late life: the long road to recovery. Am J Psychiatry 1996;153: 1620–1623
Mintz J, Mintz LI, Arruda MJ, et al. Treatments of depression and the functional capacity to work. Arch Gen Psychiatry 1992;49: 761–768
McCall WV, Reboussin BA, Cohen W, et al. Electroconvulsive therapy is associated with superior symptomatic and functional change in depressed patients after psychiatric hospitalization. J Affect Disord 2001;63: 17–25
Wing JK, Beevor AS, Curtis RH, et al. Health of the Nation Outcome Scales (HoNOS). Research and development. Br J Psychiatry 1998;172: 11–18
Ware JE, Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30: 473–483
Fisher LJ, Goldney RD, Furze PF, et al. Electroconvulsive Therapy, Depression, and Cognitive Outcomes. Journal of ECT 2004;20: 174–178
Eisen SV, Dill DL, Grob MC. Reliability and validity of a brief patient-report instrument for psychiatric outcome evaluation. Hosp Community Psychiatry 1994;45: 242–247
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9: 179–186
Prudic J, Haskett RF, Mulsant B, et al. Resistance to antidepressant medications and short-term clinical response to ECT. Am J Psychiatry 1996;153: 985–992
Beck AT, Steer RA, Garbin MG. Psychometric Properties of the Beck Depression Inventory: Twenty-Five Years of Evaluation. Clinical Psychology Review 1988;8: 77–100
McCall V, Dunn A. Cognitive deficits are associated with functional impairment in severely depressed patients. Psychiatry Res 2003;121: 179–184
Alexopoulos GS, Vrontou C, Kakuma T, et al. Disability in geriatric depression. Am J Psychiatry 1996;153: 877–885
McCall WV, Dunn A, Rosenquist PB. Quality of life and function after ECT. British Journal of Psychiatry 2004; 405–409
McCall WV, Dunn AG. Cognitive deficits are associated with functional impairment in severely depressed patients. Psychiatry Res 2003;121: 179–184
Iodice AJ, Dunn AG, Rosenquist P, et al. Stability over time of patients’ attitudes toward ECT. Psychiatry Res 2003;117: 89–91
Sackeim HA, Ross FR, Hopkins N, et al. Subjective Side Effects Acutely Following ECT: Associations with Treatment Modality and Clinical Response. Convuls Ther 1987;3: 100–110
Brodaty H, Berle D, Hickie I, et al. “Side effects” of ECT are mainly depressive phenomena and are independent of age. J Affect Disord 2001;66: 237–245
Rami-Gonzalez L, Bernardo M, Boget T, et al. Subtypes of memory dysfunction associated with ECT: characteristics and neurobiological bases. J ECT 2001;17: 129–135
McCall W, Prudic J, Olfson M, et al. Health-related quality of life following ECT in a large community sample. 2006:
Oslin DW, Streim J, Katz IR, et al. Change in disability follows inpatient treatment for late life depression. J Am Geriatr Soc 2000;48: 357–362
Goldman HH, Skodol AE, Lave TR. Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 1992;149: 1148–1156
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12: 189–198
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 springer
About this chapter
Cite this chapter
Rosenquist, P.B., McCall, W.V. (2007). Quality of life outcomes of ECT. In: Ritsner, M.S., Awad, A.G. (eds) Quality of Life Impairment in Schizophrenia, Mood and Anxiety Disorders. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-5779-3_17
Download citation
DOI: https://doi.org/10.1007/978-1-4020-5779-3_17
Publisher Name: Springer, Dordrecht
Print ISBN: 978-1-4020-5777-9
Online ISBN: 978-1-4020-5779-3
eBook Packages: MedicineMedicine (R0)