The clinical use of electroconvulsive therapy (ECT) — for any disorder — is often seen as both antiquated and barbaric by the general public. However, a new observational study on older adults with mood disorders showed a marked reduction in the risk of long-term all-cause mortality and short-term suicide in patients who received ECT, according to research from Yale University.
Pop cultural depictions of electroconvulsive therapy, like those seen in One Flew Over the Cuckoo’s Nest or Requiem for a Dream, have led to the widespread misunderstanding of what it is, how it is used in clinical settings, and what it can treat.
But the use of ECT has proven to be both safe and effective in the treatment of some treatment-resistant disorders, such as depression and bipolar disorder. In fact, for some patients where other treatment options have previously failed, the treatment can be a godsend.
What is ECT?
Electroconvulsive therapy involves administering a brief electrical stimulation to the brain of patients while they are under anesthesia. In this study, researchers observed 41,260 participants aged 65 or older, with an average age of 75. Each of the participants had been admitted as an inpatient for a psychiatric diagnosis of some type, and roughly one-quarter of participants were given ECT at a therapeutic level.
Participants who received ECT had a decreased risk of death from all causes one year after discharge. Additionally, a substantial reduction in suicide rates was observed in the first three months after discharge for those participants who received ECT, indicating both short and long-term benefits for patients.
While a decrease in suicide rates was observed three months after discharge for those who received ECT, there was no change in suicide rate one year after discharge—indicating the benefits may wear out over time. Given these findings, the use of ECT should be more widely considered as an option for inpatients with mood disorders, particularly those who are seen as a short-term suicide risk, according to the study.
Looking to the future
Researchers also observed a clear distinction in the outcomes for those who received therapeutic ECT levels versus sub-therapeutic levels, which involves the administration of the therapy at a level lower than traditionally prescribed.
“I think one of the most striking things from our study was the strong association of ECT and a reduction in mortality among older adults. This had been shown by prior research, but one of the interesting things was how the individuals receiving sub-therapeutic ECT had an almost identical risk of mortality as those who did not receive ECT for the first three months following hospitalization,” said senior author, Samuel Wilkinson, in a statement.
The general public may still misinterpret the use of electroconvulsive therapy. But the substantial benefits found in the controlled, clinical use of ECT for certain disorders appears undeniable, according to researchers.
This study was originally published in The American Journal of Psychiatry.
Article written by Adam Swierk