Chifai Tam, Lingling Zhao, Haohao Yan, Ying Peng, Wenbin Guo
ECT demonstrates therapeutic effects across all age groups of patients with MDD. The older group seemed to benefit more from this treatment modality compared to other age groups. These findings contribute to a better understanding of the differential effects of ECT in patients with MDD of different ages, which may guide clinical decision-making.
BACKGROUND: Major depressive disorder (MDD) has become one of the diseases that seriously affects the quality of life and social function of patients. Electroconvulsive therapy (ECT) is an important method for treating mental disorders. This study aims to conduct a comparison of symptomatic improvement in patients with MDD across different age groups following ECT, thereby providing more precise and personalized treatment plans.
METHODS: PubMed, Cochrane Library, CNKI, Wanfang, and other databases were searched for related studies from self-built databases until February 2025. The retrieved studies were then subjected to a meta-analysis using R software. Based on the assessment of heterogeneity across studies, either a fixed-effect model or a random-effect model was selected for data synthesis.
RESULTS: A total of 15 eligible articles were included in this meta-analysis, involving 1617 patients with MDD. The results indicated ECT could reduce the scores of the Hamilton Depression Rating Scale (HAMD), Montgomery-Åsberg Depression Rating Scale (MADRS), and Hamilton Anxiety Rating Scale (HAMA). Additionally, it could increase the scores of the Mini-Mental State Examination (MMSE). However, no statistical significance was observed on the subscales of the Wechsler Memory Scale (WMS). Subgroup analysis and meta-regression revealed that the older patients (>60 years old) may benefit more significantly in improving depressive symptoms (HAMD and MADRS) and WMS recognition memory. No significant age-related differences are observed in HAMA, MMSE, or other WMS subtests.
CONCLUSIONS: ECT demonstrates therapeutic effects across all age groups of patients with MDD. The older group seemed to benefit more from this treatment modality compared to other age groups. These findings contribute to a better understanding of the differential effects of ECT in patients with MDD of different ages, which may guide clinical decision-making.