Hostname: page-component-7f64f4797f-bnl7t Total loading time: 0 Render date: 2025-11-03T05:55:55.600Z Has data issue: false hasContentIssue false
  • English
  • Français

The Role of Electroconvulsive Therapy in the Treatment of Depressive Illness in Old Age

Published online by Cambridge University Press:  02 January 2018

Susan M. Benbow
Susan M. Benbow*
Affiliation:
York House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX
Get access Rights & Permissions [Opens in a new window]

Abstract

Electroconvulsive therapy is an important treatment in the depressive states of late life, and there is general agreement about the indications for its use in old age psychiatry. Indeed, old age may be associated with a better response to ECT than that in younger age groups. The additional risk involved through physical problems in the elderly is not great when compared with that of continuing depression and of the side-effects of alternative treatments. Temporary memory disorders and confusion may occur, but are minimised if unilateral electrode placement is used. Some patients treated with unilateral ECT do not respond, but will respond to bilateral treatment. Anxiety over unwanted treatment effects, which can lead to ineffective treatment of depressive illness, must be outweighed by knowledge of the dangers of leaving depression untreated in old age.

Information

Type
Review Article
Information
The British Journal of Psychiatry , Volume 155 , Issue 2 , August 1989 , pp. 147 - 152
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Abrams, R. (1982) Technique of electroconvulsive therapy In Electroconvulsive Therapy: Biological Foundations and Clinical Applications (ed. Abrams R. & Essman W. B.). Lancaster: MTP Press.Google Scholar
Abrams, R. (1986) A hypothesis to explain divergent findings among studies comparing the efficacy of unilateral and bilateral ECT in depression. Convulsive Therapy, 2, 253–257.Google Scholar
Abrams, R., Fink, M. & Feldstein, S. (1973) Prediction of clinical response to ECT. British Journal of Psychiatry, 122, 457–460.CrossRefGoogle ScholarPubMed
Abrams, R., Fink, M. & Volavka, J. (1982) Electroencephalographic effects of convulsive therapy In Electroconvulsive Therapy: Biological Foundations and Clinical Applications (ed. Abrams R. & Essman W. B.). Lancaster: MTP Press.Google Scholar
Abrams, R., Taylor, M. A., Faber, R., et al (1983) Bilateral versus unilateral ECT: efficacy in melancholia. American Journal of Psychiatry, 140, 463–465.Google Scholar
Alexopoulos, G. S., Shamoian, C. J., Lucas, J., et al (1984) Medical problems of geriatric psychiatric patients and younger controls during electroconvulsive therapy. Journal of the American Geriatrics Society, 32, 651–654.CrossRefGoogle ScholarPubMed
Atre-Vaidya, N. & Jampala, V. C. (1988) Electroconvulsive therapy in Parkinsonism with affective disorder. British Journal of Psychiatry, 152, 55–58.Google Scholar
Babigian, H. M. & Guttmacher, L. B. (1984) Epidemiologic considerations in electroconvulsive therapy. Archives of General Psychiatry, 41, 246–253.Google Scholar
Baldwin, R. C. (1988) Delusional and non-delusional depression in late life. Evidence for distinct subtypes. British Journal of Psychiatry, 152, 39–44.Google Scholar
Baldwin, R. C. & Jolley, D. J. (1986) The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.Google Scholar
Benbow, S. M. (1985) Electroconvulsive therapy in psychogeriatric practice. Geriatric Medicine, 15, 19–22.Google Scholar
Benbow, S. M. (1987) The use of electroconvulsive therapy in old age psychiatry. International Journal of Geriatric Psychiatry, 2, 25–30.Google Scholar
Benbow, S. M. (1988) ECT for depression in dementia. British Journal of Psychiatry, 152, 859.CrossRefGoogle ScholarPubMed
Brandon, S., Cowley, P., McDonald, C., et al (1984) Electroconvulsive therapy: results in depressive illness from the Leicestershire trial. British Medical Journal, 288, 22–25.CrossRefGoogle ScholarPubMed
Burke, W. J., Rutherford, J. L., Zorumski, C. F., et al (1985) Electroconvulsive therapy and the elderly. Comprehensive Psychiatry, 26, 480–486.Google Scholar
Dally, P. & Connolly, J. (1981) Electro-convulsion therapy In An Introduction to Physical Methods of Treatment in Psychiatry. Edinburgh: Churchill Livingstone.Google Scholar
Dec, G. W., Stem, T. A. & Welch, C. (1985) The effects of electroconvulsive therapy on serial electrocardiograms and serum cardiac enzyme values. A prospective study of depressed hospitalised in-patients. Journal of the American Medical Association, 253, 2525–2529.CrossRefGoogle Scholar
DeVine, R., Newton, K. J. & Spear, F. G. (1964) Pain following ECT modified by muscle relaxants. British Medical Journal, ii, 1046–1048.Google Scholar
Faber, R. (1983) Dental fracture during ECT. American Journal of Psychiatry, 140, 1255–1256.Google ScholarPubMed
Folstein, M., Folstein, S. & McHuoh, P. R. (1973) Clinical predictors of improvement after electroconvulsive therapy of patients with schizophrenic, neurotic reactions and affective disorders. Biological Psychiatry, 7, 147–152.Google Scholar
Fontaine, R. & Young, T. (1985) Unilateral ECT: advantages and efficacy in the treatment of depression. Canadian Journal of Psychiatry, 30, 142–147.Google Scholar
Fraser, R. M. (1981) ECT and the elderly In Electroconvulsive Therapy: An Appraisal (ed. Palmer R. L.). Oxford: Oxford University Press.Google Scholar
Fraser, R. M. & Glass, I. B. (1978) Recovery from ECT in elderly patients. British Journal of Psychiatry, 133, 524–528.Google Scholar
Fraser, R. M. & Glass, I. B. (1980) Unilateral and bilateral ECT in elderly patients: a comparative study. Acta Psychiatrica Scandinavica, 62, 13–31.Google Scholar
Gaspar, D. & Samarasinghe, L. A. (1982) ECT in psychogeriatric practice - a study of risk factors, indications and outcome. Comprehensive Psychiatry, 23, 170–175.CrossRefGoogle Scholar
Gerring, J. P. & Shields, H. M. (1982) The identification and management of patients with a high risk for cardiac arrhythmias during modified ECT. Journal of Clinical Psychiatry, 43, 140–143.Google ScholarPubMed
Godber, C. (1983) Depression in old age. British Medical Journal, 287, 758.Google Scholar
Godber, C., Rosenvinge, H., Wilkinson, D., et al (1987) Depression in old age: prognosis after ECT. International Journal of Geriatric Psychiatry, 2, 19–24.Google Scholar
Gold, L. & Chiarella, C. J. (1944) The prognostic value of clinical findings in cases treated with electric shock. Journal of Nervous and Mental Disease, 100, 577–583.Google Scholar
Hamilton, M. (1982) Prediction of the response of depressions to ECT In Electroconvulsive Therapy: Biological Foundations and Clinical Applications (ed. Abrams R. & Essman W. B.). Lancaster: MTP Press.Google Scholar
Heshe, J., Roeder, E. & Theilgaard, A. (1978) Unilateral and bilateral ECT. A psychiatric and psychological study of therapeutic effect and side effects. Acta Psychiatrica Scandinavica (suppl. 275).Google Scholar
Hobson, R. F. (1953) Prognostic factors in electroconvulsive therapy. Journal of Neurology, Neurosurgery and Psychiatry, 16, 275–281.CrossRefGoogle Scholar
Impastato, D. J. & Almansi, R. J. (1943) A study of over two thousand cases of electrofit treated patients. New York State Journal of Medicine, 43, 2057–2064.Google Scholar
Irving, A. D. & Drayson, A. M. (1984) Intraperitoneal rupture of the bladder and ECT. British Medical Journal, 288, 194.Google Scholar
Johnstone, E. C., Deakin, J. F. W., Lawler, P., et al (1980) The Northwick Park electroconvulsive therapy trial. Lancet, i, 1317–1320.Google Scholar
Karlinsky, H. & Shulman, K. T. (1984) The clinical use of electroconvulsive therapy in old age. Journal of the American Geriatrics Society, 32, 183–186.Google Scholar
Kendell, R. E. (1981) The present status of electroconvulsive therapy. British Journal of Psychiatry, 139, 265–283.Google Scholar
Lambourn, J. & Gill, D. (1978) A controlled comparison of simulated and real ECT. British Journal of Psychiatry, 133, 514–519.CrossRefGoogle ScholarPubMed
Loo, H., Cuche, H. & Benkelfat, C. (1985) Electroconvulsive therapy during anticoagulant therapy. Convulsive Therapy, 1, 258–262.Google Scholar
Maletzky, B. M. (1978) Seizure duration and clinical effect in electroconvulsive therapy. Comprehensive Therapy, 19, 541–550.Google Scholar
Matthew, J. R. & Constan, E. (1964) Complications following ECT over a three-year period in a state institution. American Journal of Psychiatry, 121, 1119–1120.Google Scholar
Mendels, J. (1967) The prediction of response to electroconvulsive therapy. American Journal of Psychiatry, 124, 153–159.Google Scholar
Mielke, D. H., Winstead, D. K., Goethe, J. W., et al (1984) Multiple monitored electroconvulsive therapy: safety and efficacy in elderly depressed patients. Journal of the American Geriatric Society, 32, 180–182.Google Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.Google Scholar
Murray, G. B., Shea, V. & Conn, D. K. (1986) Electroconvulsive therapy for poststroke depression. Journal of Clinical Psychiatry, 47, 258–260.Google ScholarPubMed
Nystrom, S. (1965) On relation between clinical factors and efficacy of ECT in depression. Acta Psychiatrica Scandinavica (suppl. 181).Google Scholar
Ottosson, J-O. (1962) Electroconvulsive therapy of endogenous depression: an analysis of the influence of various factors on the efficacy of the therapy. Journal of Mental Science, 108, 694–703.Google Scholar
Perry, G. F. (1983) ECT for dementia and catatonia. Journal of Clinical Psychiatry, 44, 117.Google Scholar
Pettinati, H. M., Mathisen, K. S., Rosenberg, J., et al (1986) Meta-analytical approach to reconciling discrepancies in efficacy between bilateral and unilateral electroconvulsive therapy. Convulsive Therapy, 2, 7–17.Google ScholarPubMed
Post, F. (1978) Then and now. British Journal of Psychiatry, 133, 83–86.CrossRefGoogle ScholarPubMed
Price, T. R. P. (1981) Unilateral electroconvulsive therapy for depression. New England Journal of Medicine, 304, 53.Google Scholar
Raskind, M. (1984) Electroconvulsive therapy in the elderly. Journal of the American Geriatrics Society, 32, 177–178.CrossRefGoogle ScholarPubMed
Roberts, J. M. (1959) Prognostic factors in the electroshock treatment of depressive states 1. Clinical features from history and examination. Journal of Mental Science, 105, 693–702.Google Scholar
Salzman, C. (1982) Electroconvulsive therapy in the elderly patient. Psychiatric Clinics of North America, 5, 191–197.Google Scholar
Shankel, L. W., Dimassimo, D. A. & Whittier, J. R. (1960) Changes with age in electric convulsion reactions in mental patients. Psychiatric Quarterly, 34, 284–292.Google Scholar
Squire, L. R. (1982) Neuropsychological effects of ECT In Electroconvulsive Therapy: Biological Foundations and Clinical Applications (ed. Abrams R. & Essman W. B.). Lancaster: MTP Press.Google Scholar
Stroemgren, L. S. (1973) Unilateral versus bilateral electroconvulsive therapy. Acta Psychiatrica Scandinavica (suppl. 240).Google Scholar
Summers, W. K., Robins, E. & Reich, T. (1979) The natural history of acute organic mental syndrome after bilateral electroconvulsive therapy. Biological Psychiatry, 14, 905–912.Google ScholarPubMed
University of Louisville School of Medicine (1985) 1250 electroconvulsive treatments without evidence of brain injury. British Journal of Psychiatry, 147, 203–204.Google Scholar
Weiner, R. D. (1980) ECT and seizure threshold: effects of stimulus waveform and electrode placement. Biological Psychiatry, 15, 225–241.Google Scholar
Weiner, R. D. (1982) The role of electroconvulsive therapy in the treatment of depression in the elderly. Journal of the American Geriatrics Society, 30, 710–712.Google Scholar
West, E. D. (1981) Electroconvulsive therapy in depression: a double-blind controlled trial. British Medical Journal, 282, 355–357.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.