Journal of Ect最新文献

Introduction: Intermittent theta burst stimulation (iTBS) is a novel form of repetitive transcranial magnetic stimulation (rTMS) conducted in patients with treatment-resistant depression (TRD). In this retrospective naturalistic study, we investigated the outcome of iTBS in treatment-resistant depression patients with (ECT+) and without (ECT-) history of electroconvulsive therapy (ECT) in their current depressive episode, as well as among previous ECT responders and nonresponders.

Methods: We included 66 inpatients (57.6% women; mean age, 52.7 years) at a German University Department of Psychiatry. A binary logistic regression model was utilized to investigate the impact of ECT treatment history on response to iTBS.

Results: Overall response rate was 51.5%. History of ECT in the current episode was present in 47% of patients. In the regression model, history of ECT in the current episode was associated with significantly worse response to iTBS (odds ratio, 0.252; 95% confidence interval, 0.085-0.743; P = 0.013), whereas other disease- and treatment-related covariates had no significant impact on treatment outcome. In the ECT+ group, ECT nonresponders showed a significantly worse outcome of iTBS than ECT responders. Overall rate of treatment discontinuations was 3%.

Conclusions: In this study, iTBS was most effective in patients without history of ECT in the current episode. Previous ECT responders had better outcome following iTBS than ECT nonresponders. Hence, patients with ECT response, who had to discontinue ECT due to side effects or complications, may be considered suitable candidates to be switched to iTBS.

Abstract: Compulsive drinking of excessive quantities of water, called psychogenic polydipsia (PP), is a challenging complication of chronic psychotic disorders, which can lead to hyponatremia and downstream morbidity or mortality. Treatments include behavioral modifications such as free water restriction, medications to modify free water excretion, and psychotropic medications to target psychotic symptoms. However, in many cases, these options remain ineffective and/or intolerable, necessitating chronic institutionalization with poor patient quality of life. Here we report the use of an acute course of 8 sessions of bilateral electroconvulsive therapy (ECT) in a 57-year-old man with chronic schizophrenia, PP, and moderate hyponatremia refractory to standard treatments in an inpatient psychiatric setting. Serum sodium normalized and remained stable during and immediately following his ECT course, despite chronic hyponatremia with high variability for months prior to ECT initiation. A literature review found remarkably few reported cases of ECT for PP in chronic schizophrenia, a surprising result given the use of this modality for patients with psychotic illness in many countries. Our findings support future investigation into the clinical utility and mechanism of ECT for PP in this patient population.

Objectives: Despite the recognized benefits and safety of electroconvulsive therapy (ECT) for treating mental disorders, negative perceptions persist among both the public and mental health professionals. This stigma is often rooted in historical practices and media portrayals, despite modern advancements in the technique. This study aimed to assess the impact of simulation-based ECT education on nursing students' perceptions and knowledge regarding ECT before and after the procedure.

Methods: This study was planned to use a single-group pretest and posttest quasi-experimental design with a 3-month follow-up. Simulation-based ECT education involved 1 hour of theoretical instruction followed by hands-on learning using a high-fidelity mannequin. Final-year nursing students enrolled in a psychiatric and mental health nursing course were examined on their knowledge and perceptions of ECT before, immediately after, and 3 months following the intervention.

Results: Students reported statistically significant improvements in their perception and knowledge levels after participating in the simulation-based ECT education. The results were similar at the 3-month follow-up.

Conclusions: Simulation-based ECT education can be effectively integrated into both undergraduate and graduate nursing curricula to foster positive perceptions and enhance knowledge about ECT.

Objective: The stigma surrounding electroconvulsive therapy (ECT) among healthcare professionals can lead to a lack of training, limit accessibility to treatment, and introduce variability in its application. The aim of this study was to explore the attitudes and knowledge regarding ECT within healthcare professionals.

Methods: A total of 215 professionals from the Vallès Oriental region (Barcelona) completed the translated version of the Questionnaire on Attitudes and Knowledge of ECT (QuAKE). The relationship between attitude and knowledge scores was analyzed in relation to several demographic variables with bivariate descriptive statistics.

Results: The characteristics associated with a more unfavorable attitude and lower knowledge were being a female professional, aged under 30 years or over 50 years, belonging to the nursing assistant group, working in a setting not related to mental health, and never having witnessed an ECT session. A positive correlation was observed between attitude and knowledge about ECT.

Conclusions: This study identified nursing assistants as the group with the most unfavorable attitudes and lowest knowledge about ECT, and the social workers group had a favorable attitude despite having limited knowledge. The correlation between knowledge and attitude suggests the possibility of improving the latter through appropriate training, although these aspects are not always affected in the same way in all professional groups.

Objectives: This study was carried out with a descriptive design to evaluate the performance, comprehensiveness, reliability, and quality of Turkish YouTube videos addressing ECT.

Methods: The Turkish keywords "Elektrokonvülsif Terapi, Elektrokonvülsif Tedavi" and EKT [Electroconvulsive Therapy, Electroconvulsive Treatment and ECT] were searched on September 15, 2023, and the first 30 for each keyword and total 90 YouTube videos were examined. A form developed by the researchers was used for comprehensiveness, DISCERN for reliability, and Global Quality Scale for quality.

Results: The videos' (N = 27) average "number of views" was 546881.3 ± 1754392.2, the average "comprehensiveness score" was 4.8 ± 3.0, the average "reliability score" was 3.1 ± 2.2, and the average "quality score" was 2.6 ± 1.5. When the videos were examined for reliability, 55.6% contained good and useful information for the audience, whereas only 33.3% were of high quality. There was a significant positive correlation between comprehensiveness, reliability, and quality (P = 0.000).

Conclusions: People with psychiatric problems or their relatives resort to the Internet and platforms such as YouTube on topics for some information they are unfamiliar with, it is recommended that the content prepared in these areas be comprehensive, reliable, and of high quality.

Abstract: Catatonia is a neuropsychiatric syndrome that occurs with several psychiatric and systemic medical conditions. Central nervous system abnormalities are believed to increase the risk of catatonia, with several cases reported in patients with neurodevelopmental and neurodegenerative disorders. Lissencephaly is a spectrum of neuronal migration disorders characterized by poorly defined or absent gyri and sulci, abnormally thick cortex, and a broad array of histopathological changes. Lissencephaly has a range of etiologies, clinical signs, symptoms, and degrees of severity. It is associated with comorbidities, such as epilepsy, visual, cardiac, and skeletal problems, as well as premature mortality.In this article, we describe the case of a patient with lissencephaly who developed catatonia at 20 years of age. He was minimally responsive to treatment with a high dose of lorazepam, and catatonia subsided with the use of electroconvulsive therapy. This is the first case in our knowledge to describe the occurrence of catatonia among patients with lissencephaly and its treatment with electroconvulsive therapy.

Objectives: Shared decision making is used for reaching medical decisions, also in the management of major depressive disorder (MDD). Electroconvulsive therapy (ECT) is an effective treatment option for patients with severe MDD. However, the decision-making process, specifically the exchange of evidence-based information, for ECT may be hampered by the controversy and stigma surrounding ECT. We aim to explore the experiences of the decision-making process of patients and their relatives who have chosen to receive ECT in order to guide optimization of shared decision making in ECT.

Methods: Semistructured interviews were conducted with MDD patients and their relatives who had voluntarily received ECT between 2018-2023 at the Radboud University Medical Center, the Netherlands. The interviews were analyzed by thematic analysis.

Results: Meaning saturation occurred after 16 interviews. The following 3 major themes emerged: 1) information is key, 2) empowering the decision, and 3) lived experiences with ECT. Participants emphasized the importance of accessible information presented in a calm and stepwise manner. They also identified gaps in desired information, particularly regarding memory loss and difficulty in retaining the given information. Factors empowering the decision included support from family, healthcare professionals, peers, and desperation, while negative factors included stigma, negative images, lack of support, and fear. Lived experiences with ECT might influence a future decision. Positive experiences were improved attitudes, treatment effects, and empathic and involved professionals, while negative aspects included cognitive side effects and lack of follow-up.

Conclusions: This study offers insights into factors influencing the decision-making process in patients with MDD that received ECT. It shows possibilities for improving the decision-making process in clinical practice.