Mickey BJ, Ginsburg Y, Jensen E, et al. - Researchers aimed at gaining the information concerning the long-term outcomes in patients receiving electroconvulsive therapy (ECT) for treatment-resistant depression. Further, they sought for the individual characteristics that predict those outcomes.

• Adult patients at a single academic ECT center were assessed prospectively in this longitudinal study.

• Among 114 participants, completion of an index ECT series was recorded in 105 and there were 70 who were classified as acute ECT responders.

• Over a 2-year follow-up period, 82 subjects provided data on depression severity (Patient Health Questionnaire; PHQ-9).

• Less medication resistance, shorter index episode, and psychotic features were predictive of better acute ECT response.

• During the 2-year follow-up period, improvement in PHQ-9 scores was observed from baseline at all time points but there was a wide variation in individual scores.

• Better acute therapeutic response to ECT, but not ECT adverse effects, was predictive of lower long-term PHQ-9 scores.

• There appeared no association of married status and greater baseline clinician-rated severity with acute ECT response but these variables appeared to be predictive of lower PHQ-9 scores longitudinally, independent of other baseline features, initial ECT response, or intensity of ongoing treatment.

• Overall findings suggest a strong influence of an individual's social context on long-term but not short-term outcomes, indicating a potential target for post ECT therapeutic interventions.