›› 2018, Vol. 38 ›› Issue (1): 76-.doi: 10.3969/j.issn.1674-8115.2018.01.014

• Original article (Clinical research) • Previous Articles     Next Articles

Electroconvulsive treatment for geriatric depression: a systematic review of randomized clinical trials

SU Liang1, 2, SHI Shen-xun1, 2, LU Zheng1, 3, JIA Yu-ping1, LIANG Shi-qiao1, XU Yi-feng1   

  1. 1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai 200040, China; 3. Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai 200065, China
  • Online:2018-01-28 Published:2018-03-09
  • Supported by:
    New Frontier Technology Joint Research Project of Shanghai Municipal Hospital, SHDC12012109; Open Project of Shanghai Key Laboratory of Psychotic Disorders, 13dz2260500

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Abstract: Objective · To explore the clinical effectiveness and safety of electroconvulsive therapy (ECT) in elderly patients with depression.
Methods · Searches were made in PubMed, EMBase, Web of Knowledge, CNKI, Wanfang, VIP, CBMDisc databases and etc. CONSORT (Consolidated
Standards of Reporting Trials) statement were used to assess the methodological quality of the studies. RevMan and STATA were used to do meta analysis.Results · Ten studies were included in this systematic review. The studies which used Hamilton depression rating scale (HAMD, n=5) and MontgomeryÅsberg depression rating scale (MADRS, n=3) to access depressed symptom were analyzed. Sample size was 306 and 290 before and after treatment, respectively. The depressive symptoms were significantly improved after ECT treatment estimated by either HAMD (Z=6.39, SMD=3.64, P=0.000) or MADRS (Z=15.47, SMD=2.12, P=0.000). There was no difference of Mini-mental State Examination (MMSE) scores before and after the treatment
(Z=1.47, P=0.140). The incidence of adverse events of headache, confusion, drowsiness, nausea and vomiting was more than 5%. Conclusion · Depressed
symptoms are significantly improved in geriatric depression after ECT. The overall cognitive impairment is not obvious, but headache and disturbance of
consciousness are common.

Key words: electroconvulsive therapy, elderly, depression, randomized controlled trial, meta analysis