Development of the comprehensive treatment system for intractable midle-aged and elderly severe depression

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In the intractable middle-aged and elderly depression, a course of acute ECT had more than 80% of short-term response rate, and about 50% of 6-month remission rate after ECT. In those patients with relapse within 6 months after ECT, a course of continuation ECT had about 50% of 6-month remission rate. Age was associated with neither short-term response rate nor 6-month remission rate. However, concurrent medical condition had tendency toward association with severity of residual symptoms after ECT. In the intractable middle-aged and elderly catatonic schizophrenia, a course of acute ECT had 100% of short-term response rate and less than 50% of 6-month remission rate after ECT. In those patients with relapse within 6 months after ECT, a course of continuation ECT had about 60% of 6-month remission rate.Elderly depression and catatonia with medication resistance or intolerance are likely to have severe clinical features, often with life-threatened medical conditions and with highly relapse vulnerability after recovery from acute state. Thus, long-term comprehensive treatment strategy should be designed under the sufficient pathophysiological consideration. This study demonstrated the short-and long-term efficacy of the comprehensive treatment system which was located in a university hospital and dedicated for intractable elderly mental disorders in local medical facilities.