Table 2.

Multivariable-Adjusted Analysis of Factors Associated With ECT Use Among Older Adults With Major Depressive Disorder^a

Factor (Reference Group)	Adjusted Odds Ratio	95% CI	P Value
Age	0.98	0.98–0.98	< .001
Gender (male)	0.82	0.77–0.87	< .001
Race/ethnicity (non-Hispanic white)
Non-Hispanic black	0.57	0.49–0.67	< .001
Other	0.76	0.65–0.90	.001
Region (Northeast)
Midwest	0.85	0.79–0.92	< .001
South	0.62	0.58–0.67	< .001
West	0.58	0.53–0.64	< .001
Median household income (< $40,000)
$40,000–$59,999	1.34	1.23–1.46	< .001
≥ $60,000	1.90	1.74–2.06	< .001
Psychotherapy use	1.98	1.87–2.10	< .001
ED use	1.18	1.11–1.25	< .001
Medications prescribed (no)
Antidepressants	1.38	1.22–1.56	< .001
Antipsychotics	5.60	5.20–6.04	< .001
Anxiolytics, sedative/hypnotics	1.22	1.14–1.30	< .001
Mood stabilizers	0.77	0.72–0.81	< .001
Lithium	4.67	4.25–5.13	< .001
Stimulants	3.34	3.03–3.68	< .001
Behavioral comorbidity (no)
ADHD and other conduct disorders	0.68	0.60–0.76	< .001
Anxiety disorder	1.76	1.63–1.89	< .001
Bipolar disorder	3.24	3.05–3.45	< .001
Posttraumatic stress disorder	0.95	0.84–1.07	.368
Schizophrenia	1.67	1.57–1.78	< .001
Personality disorder	1.91	1.75–2.07	< .001
Traumatic brain injury and nonpsychotic mental disorders due to brain damage	0.72	0.60–0.85	< .0001
Alcohol use disorder	0.91	0.82–1.02	.105
Tobacco use disorder	0.66	0.60–0.72	< .001
Drug use disorders	0.97	0.89–1.06	.547

^aData are from 2014 to 2015 Medicare claims files.

Abbreviations: ADHD = attention-deficit/hyperactivity disorder, ECT = electroconvulsive therapy, ED = emergency department.