ECT in the Journal of Affective Disorders

An article in the May 2013 edition of the Journal of Affective Disorders by Dr. W. Vaughn McCall of the Medical College of Georgia and others shows that fewer than 20 per cent of patients derive significant benefit from ECT. Six months after a course of ECT over 80 per cent are either still depressed or depressed again.

When it comes to ECT psychiatrists have an amazing capacity for salvaging something positive from even the most unpromising results, as the title of the article – “Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT” – suggests.  Dr McCall put out a press release stressing the fact that the small minority of patients who found themselves in this lucky group and who had completed health-related quality of life questionnaires before and six months after a course of ECT (64 out of an original 766 who entered the multi-centre study) managed normal scores.

On the ScienceDaily website Dr McCall is quoted as saying:

“What I tell patients is that six months after this is over, my expectation is that you will be better off, not just in terms of your depression, I mean globally, in your quality of life. The trick is going to be keeping you well so you do not slide back into depression. That is the biggest risk.”

But are these expectations realistic given the results of his own research?

One interesting fact to emerge from the study is that some psychiatrists in the US still use sinewave ECT (or at least were still using it when the patients in this study underwent ECT), with 16 per cent of patients in the New York City metropolitan area group having had sinewave treatment.

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