OJD  Vol.1 No.2 , November 2012
Treating Depression with ECT: An Objective Review
The current study examined the efficacy of Electroconvulsive Therapy (ECT) as a treatment method for unipolar and bipolar depression using an objective measure through a retrospective chart review. First, this article discusses the history of ECT as well as issues in psychiatric diagnoses. Patients’ progress in this study was measured by the hospital’s psychiatrists as well as through the self-report measure, Clinically Useful Depression Scale (CUDOS). The sample consisted of 22 female and 8 male depressed inpatients and outpatients. A 2 × 2 mixed ANOVA revealed a significant interaction, showing improvement from pre-treatment to post-treatment in both genders. In post-treatment, female patients showed significantly more improvement than male patients. This study suggests that ECT results in depression reduction, especially in female patients. In addition, the CUDOS has shown to be a simple and effective self-report measure in assessing progress of depression including complex treatments, such as ECT. Recommendations for future ECT studies include: controlling for comorbidity and medication by obtaining a larger sample size to categorize patients according to medication type and dosage.

Cite this paper
Gohar, B. , Winter, C. , Benander, M. , Mandell, B. , Hobgood, C. & Brewster, K. (2012). Treating Depression with ECT: An Objective Review. Open Journal of Depression, 1, 9-14. doi: 10.4236/ojd.2012.12002.
[1]   Accornero, F. (1988). An eyewitness account of the discovery of electroshock. Convulsive Therapy, 4, 40-49.

[2]   Afifi, M. (2005). Gender differences in mental health. Singapore Medical Journal, 48, 385.

[3]   American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

[4]   Babigian, H. M., & Guttmacher, L. B. (1984). Epidemiologic considerations in electroconvulsive therapy. Archive of General Psychiatry, 41, 246-253. doi:10.1001/archpsyc.1984.01790140036005

[5]   Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archive of General Psychiatry, 4, 561-571. doi:10.1001/archpsyc.1961.01710120031004

[6]   Beyer, J. L., Glenn, M. D., & Weiner, R. D. (1998). Electroconvulsive therapy: A programmed text (2nd ed.). Arlington, VA: American Psychiatric Press.

[7]   Bloch, Y., Ratzoni, G., Mendlovic, S., Gal, G., & Levkovitz, Y. (2005). Gender differences in electroconvulsive therapy: A retrospective chart review. Journal of Affective Disorders, 84, 99-102. doi:10.1016/j.jad.2004.10.002

[8]   Campbell, S., & MacQueen, G. (2006). An update on regional brain volume differences associated with mood disorders. Current Opinion in Psychiatry, 19, 25-33. doi:10.1097/01.yco.0000194371.47685.f2

[9]   Cervilla, J. A., Molina, E., Rivera, M., Torres-González, F., Bellón, J. A., Moreno, & Gutiérrez, B. (2007). The risk for depression conferred by stressful life events is modified by variation at the serotonin transporter 5HTTLPR genotype: Evidence from the Spanish PREDICT-Gene cohort. Molecular Psychiatry, 12, 748-755. doi:10.1038/sj.mp.4001981

[10]   Daniel, W. F., & Crovitz, H. F. (1986). ECT-induced alteration of psychogenic amnesia. Acta Psychiatrica Scandinavica, 74, 302-303. doi:10.1111/j.1600-0447.1986.tb06247.x

[11]   Di Pauli, J., & Conca, A. (2009). Impact of seizure duration in maintenance electroconvulsive therapy. Psychiatry and Clinical Neurosciences, 63, 769-771. doi:10.1111/j.1440-1819.2009.02028.x

[12]   Duman, R. S., & Monteggia, L. M. (2006). A neurotrophic model for stress-related mood disorders. Biological Psychiatry, 59, 1116-1127.

[13]   Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136. doi:10.1126/science.847460

[14]   Fink, M. (1984). Meduna and the origins of convulsive therapy. American Journal of Psychiatry, 141, 1034-1041.

[15]   Flint, A. J., & Gagnon, N. (2002). Effective use of electroconvulsive therapy in late-life depression. Canadian Journal of Psychiatry, 47, 734-741.

[16]   Gilbody, S., House, A., & Sheldon, T. (2002). Psychiatrists in the UK do not use outcomes measures. British Journal of Psychiatry, 180, 101-103.

[17]   Gorman, J. M. (2006). Gender differences in depression and response to psychotropic medication. Gender Medicine, 3, 93-109. doi:10.1016/S1550-8579(06)80199-3

[18]   Jenkusky, S. M. (1992). Public perception of electroconvulsive therapy: A historical review. Jefferson Journal of Psychiatry, 10, 2-11.

[19]   Keddy, P., & Erdberg, P. (2010). Changes in the Rorschach and MMPI-2 after electroconvulsive therapy (ECT): A collaborative assessment case study. Journal of Personality Assessment, 92, 279-295. doi:10.1080/00223891.2010.481982

[20]   Kendler, K. S., Gatz, M., Gardner, C. O., & Pederse, N. L. (2006). Personality and major depression. Archives of General Psychiatry, 63, 1113-1120. doi:10.1001/archpsyc.63.10.1113

[21]   Kessler, R. C., McGonagle, K. A., Nelson, C. B., Hughes, M., Swartz, M., & Blazer, D. G. (1994). Sex and depression in the National Comorbidity Survey II: Cohort effects. Journal of Affective Disorders, 30, 15-26. doi:10.1016/0165-0327(94)90147-3

[22]   Kim, J. M., Stewart, R., Kim, S. W., Yang, S. J., & Shin, I. S. (2007). Interactions between life stressors and susceptibility genes (5-HT- TLPR and BDNF) on depression in Korean elders. Biological Psychiatry, 62, 423-428. doi:10.1016/j.biopsych.2006.11.020

[23]   Le Strat, Y., & Gorwood, P. (2007). Mortality in electroconvulsive therapy. British Journal of Psychiatry, 191, 362. doi:10.1192/bjp.191.4.362

[24]   MacQueen, G., Parkin, C., Marriott, M., Bégin, H., & Hasey, G. (2007). The long-term impact of treatment with electroconvulsive therapy on discrete memory systems in patients with bipolar disorder. Journal of Psychiatry and Neuroscience, 32, 241-249.

[25]   Mahmoud, R. A., Pandina, G. J., Turkoz, I., Kozik-Gonzalez, C., Canuso, C. M., Kujawa, M. J., & Gharabawi-Garbaldi, G. (2007). Risperidone for treatment-refractory major depressive disorder: A randomized trial. Annals of Internal Medicine, 147, 593-603.

[26]   Murray, C., & Lopez, A. (1996). The global burden of disease. Cambridge, MA: Harvard University Press.

[27]   Rot, M., Mathew, S. J., & Charney, D. S. (2009). Neurobiological mechanisms in major depressive disorder. Canadian Medical Association Journal, 180, 305-313. doi:10.1503/cmaj.080697

[28]   Ruhe, H. G., Mason, N. S., & Schene, A. H. (2007). Mood is indirectly related to serotonin, norepinephrine and dopamine levels in humans: A meta-analysis of monoamine depletion studies. Molecular Psychiatry, 12, 331-359. doi:10.1038/sj.mp.4001949

[29]   Sackeim, H. A., Prudic, J., Fuller, R., Keilp, J., Lavori, P. W., & Olfson, M. (2006). The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 32, 244-254. doi:10.1038/sj.npp.1301180

[30]   Winkler, D., Pjerk, E., & Kasper, S. (2006). Gender-specific symptoms of depression and anger attacks. Journal of Men's Health and Gender, 30, 19-24. doi:10.1016/j.jmhg.2005.05.004

[31]   Yatham, L. N., Liddle, P. F., Lam, R. W., Zis, A. P., Stoessl, A. J., Sossi, V., & Ruth, T. J. (2010). Effect of electroconvulsive therapy on brain 5-HT2 receptors in major depression. British Journal of Psychiatry, 197, 499-500.

[32]   Zimmerman, M., & Mattia, J. I. (2001). A self-report scale to help make psychiatric diagnoses: The Psychiatric Diagnostic Screening Questionnaire (PDSQ). Archives of General Psychiatry, 58, 787-94.

[33]   Zimmerman, M., Chelminski, I., McGlinchey, J. B., & Posternak, M. A. (2008). A clinically useful depression outcome scale. Comprehensive Psychiatry, 49, 131-140. doi:10.1016/j.comppsych.2007.10.006