One-year outcome of elderly inpatients with major depressive disorder treated with ECT and antidepressants

We report the acute response and outcome in 1-year follow-up of 51 elderly depressive inpatients with major depressive disorder treated with electroconvulsive therapy (ECT) (n = 30) and/or antidepressant therapy (n = 21). The patients were assessed at admission, at discharge, and after 1 year according to the Montgomery and Asberg Depression Rating Scale, the Beck Depression Inventory, and the Clinical Global Impression Scale. The acute response was good. Montgomery and Asberg Depression Rating Scale total scores diminished significantly during index hospitalization within both groups (from 31.6 +/- 8.5, to 8.1 +/- 6.0 in the ECT group and from 28.5 +/- 5.4 to 13.4 +/- 10.6 in the antidepressant group). The 1-year rehospitalization rate for the entire group, however, was 21 of 51 patients (41%), 13 of 30 patients (43%) in the ECT group, and 8 of 21 (38%) in the antidepressant group. Six of 13 patients in the ECT group and 1 of 8 patients in the antidepressant group were rehospitalized during the first month after discharge. The results suggest a good acute therapeutic response to both ECT and antidepressive therapy in elderly patients with MDD. The major finding in this study was the relatively high rehospitalization rate, which emphasizes the need for careful follow-up of the elderly patients who have recovered from a depressive episode.