n this issue of the Nordic Journal of Psychiatry [Citation1] show that pulsewidth has no effect on quality of life after ECT; quality of life (QOL) improves with any pulsewidth ECT. This is not surprising, given that QOL is a blunt measure and ECT is so effective that most techniques work quite well. Is QOL a proxy for preserved antidepressant efficacy, or preserved cognition, or both? It would be most helpful to have data on depression symptoms and cognitive outcomes from the Swedish register, as well as the QOL data