Pub Date : 2019-07-24DOI: 10.1097/YCT.0000000000000619
Wei-Cheng Yang, Ching-Hua Lin, Cheng-Chung Chen
Objectives Major depressive disorder is a recurrent illness. Treatment strategies are generally focused on achieving remission and preventing relapse/recurrence. The aim of this study was to explore the risk factors associated with relapse for remitted patients during the 12-week follow-up. Methods This was an open-label trial for major depressive disorder patients receiving acute treatments with electroconvulsive therapy (ECT) and continuation medication in the 12-week follow-up. Symptom severity and psychosocial functioning were assessed using the 17-item Hamilton Rating Scale for Depression (HAMD-17) and the Work and Social Adjustment Scale at each visit. Remission was defined as a HAMD-17 of 7 or less after acute treatment. Relapse was defined as a HAMD-17 of 14 or greater. Subjects achieving remission after acute treatments were included for analysis. Survival analysis was used to investigate the factors associated with relapse. Results Sixty patients receiving ECT for acute treatment were enrolled for 12-week follow-up. Using Cox regression analysis, a greater number of previous major depressive episodes and greater baseline Work and Social Adjustment Scale scores were significantly associated with shorter time to relapse. Conclusions The goal of acute treatment should focus on functional remission to prevent relapse. Further studies related to more effective treatments to prevent relapse after acute ECT are required in the future.
{"title":"Risk Factors of Relapse After Successful Electroconvulsive Therapy for Taiwanese Patients With Major Depression","authors":"Wei-Cheng Yang, Ching-Hua Lin, Cheng-Chung Chen","doi":"10.1097/YCT.0000000000000619","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000619","url":null,"abstract":"Objectives Major depressive disorder is a recurrent illness. Treatment strategies are generally focused on achieving remission and preventing relapse/recurrence. The aim of this study was to explore the risk factors associated with relapse for remitted patients during the 12-week follow-up. Methods This was an open-label trial for major depressive disorder patients receiving acute treatments with electroconvulsive therapy (ECT) and continuation medication in the 12-week follow-up. Symptom severity and psychosocial functioning were assessed using the 17-item Hamilton Rating Scale for Depression (HAMD-17) and the Work and Social Adjustment Scale at each visit. Remission was defined as a HAMD-17 of 7 or less after acute treatment. Relapse was defined as a HAMD-17 of 14 or greater. Subjects achieving remission after acute treatments were included for analysis. Survival analysis was used to investigate the factors associated with relapse. Results Sixty patients receiving ECT for acute treatment were enrolled for 12-week follow-up. Using Cox regression analysis, a greater number of previous major depressive episodes and greater baseline Work and Social Adjustment Scale scores were significantly associated with shorter time to relapse. Conclusions The goal of acute treatment should focus on functional remission to prevent relapse. Further studies related to more effective treatments to prevent relapse after acute ECT are required in the future.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127043724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/YCT.0000000000000532
P. Sienaert
“T oday (...) catatonia is edging its way back to center stage as an independent disorder,” Shorter and Fink state in their new book on the history of this startling syndrome. Thanks, not least, to the authors' relentless effort. Edward Shorter is professor of the history of medicine at the University of Toronto. Max Fink, professor of psychiatry and neurology, emeritus, worked at Stony Brook School of Medicine, New York. The former has written extensively about the history of electroconvulsive therapy (ECT); the latter, Fink, is the history of ECT. One expects to read a history book. But The Madness of Fear is so much more than that. Some phrases are so literary that one cannot resist the temptation to read them aloud repetitively making one's family members frown. Here is one: “Buffeted by psychoanalysis and blinded by the prestige of German learning, clinicians let catatonia languish in the quagmire of schizophrenia” (p117). The authors “join other scholars in the growing disbelief about ‘schizophrenia’” (p120). Throughout the book, they don't pass up a chance to criticize the concept of schizophrenia that, according to Meduna, already in 1946, “doesn't mean anything more than ‘crazy’ or ‘cracked’” (p78). Not only do the authors unfold the history of catatonia, from Kahlbaum's predecessors in the early 19th century (chapter 2, “Catatonia Before Kahlbaum”) up to the so-called “resignation syndrome”marked by stupor among refugee children coming to Sweden, first described not more than 2 years ago. They also offer the reader a clinical lesson. Fink and Shorter want the reader to recognize the clinical picture of catatonia, to detect a severe condition that is fairly easy to cure. In an erawhere it is “bon ton” to hail dimensional diagnoses and demonize categorical labeling, Fink states it is our job as medical doctors to label our patients, provided that the label specifies an identifiable syndrome and brings a successful treatment (Fink, personal communication, May 6, 2018). A myriad of case descriptions with a sense of phenomenological detail that has
{"title":"The Madness of Fear—A History of Catatonia","authors":"P. Sienaert","doi":"10.1097/YCT.0000000000000532","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000532","url":null,"abstract":"“T oday (...) catatonia is edging its way back to center stage as an independent disorder,” Shorter and Fink state in their new book on the history of this startling syndrome. Thanks, not least, to the authors' relentless effort. Edward Shorter is professor of the history of medicine at the University of Toronto. Max Fink, professor of psychiatry and neurology, emeritus, worked at Stony Brook School of Medicine, New York. The former has written extensively about the history of electroconvulsive therapy (ECT); the latter, Fink, is the history of ECT. One expects to read a history book. But The Madness of Fear is so much more than that. Some phrases are so literary that one cannot resist the temptation to read them aloud repetitively making one's family members frown. Here is one: “Buffeted by psychoanalysis and blinded by the prestige of German learning, clinicians let catatonia languish in the quagmire of schizophrenia” (p117). The authors “join other scholars in the growing disbelief about ‘schizophrenia’” (p120). Throughout the book, they don't pass up a chance to criticize the concept of schizophrenia that, according to Meduna, already in 1946, “doesn't mean anything more than ‘crazy’ or ‘cracked’” (p78). Not only do the authors unfold the history of catatonia, from Kahlbaum's predecessors in the early 19th century (chapter 2, “Catatonia Before Kahlbaum”) up to the so-called “resignation syndrome”marked by stupor among refugee children coming to Sweden, first described not more than 2 years ago. They also offer the reader a clinical lesson. Fink and Shorter want the reader to recognize the clinical picture of catatonia, to detect a severe condition that is fairly easy to cure. In an erawhere it is “bon ton” to hail dimensional diagnoses and demonize categorical labeling, Fink states it is our job as medical doctors to label our patients, provided that the label specifies an identifiable syndrome and brings a successful treatment (Fink, personal communication, May 6, 2018). A myriad of case descriptions with a sense of phenomenological detail that has","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"282 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127478158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.1097/yct.0000000000000520
{"title":"International Society for ECT and Neurostimulation Annual Meeting Abstracts 2018","authors":"","doi":"10.1097/yct.0000000000000520","DOIUrl":"https://doi.org/10.1097/yct.0000000000000520","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125930146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-01DOI: 10.1097/00124509-900000000-99220
L. Smith-Martinez, L. Chatham, Purushothaman Muthukanagaraj
{"title":"Intramuscular Ketamine Protocol as an Alternative to Physical Restraints for Electroconvulsive Therapy Administration in a Psychotic Patient","authors":"L. Smith-Martinez, L. Chatham, Purushothaman Muthukanagaraj","doi":"10.1097/00124509-900000000-99220","DOIUrl":"https://doi.org/10.1097/00124509-900000000-99220","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131067185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/00124509-900000000-99227
Dimitry Francois, Tiffany Huang
{"title":"Successful Treatment With Electroconvulsive Therapy of a Patient With Chiari Malformation Type I","authors":"Dimitry Francois, Tiffany Huang","doi":"10.1097/00124509-900000000-99227","DOIUrl":"https://doi.org/10.1097/00124509-900000000-99227","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122728603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/00124509-900000000-99224
J. Miron, Véronique Desbeaumes Jodoin, M. Fournier-Gosselin, P. Lespérance
{"title":"Safety of Transcranial Magnetic Stimulation in an Obsessive-Compulsive Disorder Patient With Deep Brain Stimulation","authors":"J. Miron, Véronique Desbeaumes Jodoin, M. Fournier-Gosselin, P. Lespérance","doi":"10.1097/00124509-900000000-99224","DOIUrl":"https://doi.org/10.1097/00124509-900000000-99224","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126898630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-01DOI: 10.1097/yct.0000000000000488
M. Fink
I t has been 8 decades since seizures were successfully induced by electricity to quickly relieve the excitement of a delirious man, launching the electroshock era. The decades have been stormy with electroshock widely stigmatized, deprecated in the press and in film, practitioners placarded, and the treatments legislatively restricted. An ongoing resurgence of interest is well seen in these 2 reviews of electroshock in central European countries. The multiauthored professional text describes the widespread availabilty in almost all psychiatric facilities in the German-speaking countries. One essay describes the scene in Italy where the government in 1978 legislatively
{"title":"Electroconvulsive Therapy Revival in German Speaking Countries","authors":"M. Fink","doi":"10.1097/yct.0000000000000488","DOIUrl":"https://doi.org/10.1097/yct.0000000000000488","url":null,"abstract":"I t has been 8 decades since seizures were successfully induced by electricity to quickly relieve the excitement of a delirious man, launching the electroshock era. The decades have been stormy with electroshock widely stigmatized, deprecated in the press and in film, practitioners placarded, and the treatments legislatively restricted. An ongoing resurgence of interest is well seen in these 2 reviews of electroshock in central European countries. The multiauthored professional text describes the widespread availabilty in almost all psychiatric facilities in the German-speaking countries. One essay describes the scene in Italy where the government in 1978 legislatively","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132337713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.1097/YCT.0000000000000383
J. Obbels, E. Verwijk, F. Bouckaert, P. Sienaert
Background A significant proportion of electroconvulsive therapy (ECT)–treated patients experience anxiety anticipating the treatment, often to such an extent that they refuse or discontinue a much-needed treatment. Despite its great impact on treatment adherence, anxiety in patients receiving ECT is underexposed in the scientific literature. Objectives We aimed to review the prevalence and specific subjects of ECT-related anxiety and therapeutic interventions to reduce it. Methods We performed a computerized search (EMBASE, MEDLINE, and PsycINFO) for articles meeting the following inclusion criteria: (1) qualitative (interview) studies, quantitative (questionnaire) studies, or experimental (interventional) studies that (2) report on anxiety that is related to a planned, ongoing, or past ECT treatment. Results Of 1160 search results, 31 articles were included. Electroconvulsive therapy–related anxiety is estimated to be present in 14% to 75% of patients and is most often linked to worries about memory impairment or brain damage. Only a few interventions (chlorpromazine, meprobamate, propofol, a talking-through technique, an information leaflet, and animal-assisted therapy) have been proposed to reduce patients’ ECT-related anxiety. Conclusions Electroconvulsive therapy–related anxiety is a highly prevalent phenomenon, and the literature provides little guidance for its clinical management. Most studies are of a low methodological quality and suffer from significant limitations, thereby hampering generalized conclusions. Given the clinical importance of ECT-related anxiety, further study on its nature and evolution through the course of treatment and on anxiety-reducing interventions is warranted.
{"title":"ECT-Related Anxiety: A Systematic Review","authors":"J. Obbels, E. Verwijk, F. Bouckaert, P. Sienaert","doi":"10.1097/YCT.0000000000000383","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000383","url":null,"abstract":"Background A significant proportion of electroconvulsive therapy (ECT)–treated patients experience anxiety anticipating the treatment, often to such an extent that they refuse or discontinue a much-needed treatment. Despite its great impact on treatment adherence, anxiety in patients receiving ECT is underexposed in the scientific literature. Objectives We aimed to review the prevalence and specific subjects of ECT-related anxiety and therapeutic interventions to reduce it. Methods We performed a computerized search (EMBASE, MEDLINE, and PsycINFO) for articles meeting the following inclusion criteria: (1) qualitative (interview) studies, quantitative (questionnaire) studies, or experimental (interventional) studies that (2) report on anxiety that is related to a planned, ongoing, or past ECT treatment. Results Of 1160 search results, 31 articles were included. Electroconvulsive therapy–related anxiety is estimated to be present in 14% to 75% of patients and is most often linked to worries about memory impairment or brain damage. Only a few interventions (chlorpromazine, meprobamate, propofol, a talking-through technique, an information leaflet, and animal-assisted therapy) have been proposed to reduce patients’ ECT-related anxiety. Conclusions Electroconvulsive therapy–related anxiety is a highly prevalent phenomenon, and the literature provides little guidance for its clinical management. Most studies are of a low methodological quality and suffer from significant limitations, thereby hampering generalized conclusions. Given the clinical importance of ECT-related anxiety, further study on its nature and evolution through the course of treatment and on anxiety-reducing interventions is warranted.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116131775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.1097/YCT.0000000000000381
Eva Hundrup, M. Osler, M. Jørgensen
Objective The aim of this study was to determine status and variations in the practice of electroconvulsive treatment (ECT) in Denmark in patient characteristics, indications, treatment patterns, and hospital region. Method All 140,627 ECTs registered in the Danish National Patient Registry between 2008 and 2014 were retrieved together with information on patient characteristics. Annual treated person rates were calculated for sex, age, admission diagnosis, and region. Results The overall ECT treatment rate was 36 (95% confidence interval, 34–38) per 100,000 resident population during the study period. The rate was highest in women and increased with age. There were modest, however, stable regional differences in rates (extremal quotient = 1.4). Electroconvulsive treatment was most commonly used in patients with depression with (19.4%) or without (54.9%) psychotic symptoms. The median number of ECTs administered per patient was 10 and highest in patients with schizophrenia, schizoaffective, or bipolar disorders. A total of 51%, 14%, and 33% of ECTs were administered with bilateral, unilateral, and unspecified electrode placement, respectively. There were regional differences in electrode placement specification and use. Conclusions Although some variation was seen across hospital regions and electrode placement, ECT in Denmark was provided with relative stability over time and indications compared with most other countries in Europe and North America.
{"title":"Time Trends and Variations in Electroconvulsive Treatment in Denmark 2008 to 2014: A Nationwide Register-Based Study","authors":"Eva Hundrup, M. Osler, M. Jørgensen","doi":"10.1097/YCT.0000000000000381","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000381","url":null,"abstract":"Objective The aim of this study was to determine status and variations in the practice of electroconvulsive treatment (ECT) in Denmark in patient characteristics, indications, treatment patterns, and hospital region. Method All 140,627 ECTs registered in the Danish National Patient Registry between 2008 and 2014 were retrieved together with information on patient characteristics. Annual treated person rates were calculated for sex, age, admission diagnosis, and region. Results The overall ECT treatment rate was 36 (95% confidence interval, 34–38) per 100,000 resident population during the study period. The rate was highest in women and increased with age. There were modest, however, stable regional differences in rates (extremal quotient = 1.4). Electroconvulsive treatment was most commonly used in patients with depression with (19.4%) or without (54.9%) psychotic symptoms. The median number of ECTs administered per patient was 10 and highest in patients with schizophrenia, schizoaffective, or bipolar disorders. A total of 51%, 14%, and 33% of ECTs were administered with bilateral, unilateral, and unspecified electrode placement, respectively. There were regional differences in electrode placement specification and use. Conclusions Although some variation was seen across hospital regions and electrode placement, ECT in Denmark was provided with relative stability over time and indications compared with most other countries in Europe and North America.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115714612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：