The purpose of the study was to investigate whether the Antonovsky Sense of Coherence test administered before and after ECT can contribute more information pertinent to outcome than a test of depression.

Twenty patients with a severe unipolar or bipolar depression underwent a series of unipolar ECT under standard conditions. As part of the routine of the department, the patients filled in, before and after ECT, the following questionnaires: Beck Depression Inventory (Beck), 20 item version and Antonovsky Sense of Coherence test (SOC), 13 item version.

Mean age was 40.3, somewhat less for women.

Fourteen patients were living alone.

A reduction was obtained, not significantly different in uni- or bipolar depression, from 35 to 17 in total score on Beck. Likewise, the SOC value increased from a mean of 2.5 to 3.2, indicating a better manageability, comprehensibility and meaningfulness in life.

Four patients had an invalidity pension. Ten of the 16 remaining patients attained work after ECT, and scored better than those not starting to work on both tests, SOC > Beck. A low SOC value may indicate increased mortality risk.

Patients who are favourably treated with ECT against any depression, but who do not show a considerable improvement in SOC, would need special follow-up on factors not directly related to mental illness to reduce relapse and mortality risk.