The Journal of ECT最新文献

{"title":"Negative Pressure Pulmonary Edema after Electroconvulsive Therapy.","authors":"David Mansoor, C. Trevino, L. Ganzini, M. Zornow","doi":"10.1097/YCT.0000000000000284","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000284","url":null,"abstract":"","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124783391","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}

{"title":"Attempted Suicide by Breaking Pre-Electroconvulsive Therapy Fasting.","authors":"A. Tavares, F. Volpe","doi":"10.1097/YCT.0000000000000283","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000283","url":null,"abstract":"CASE REPORT A 64-year-old male bipolar I patient in a severe depressive episode was referred to outpatient electroconvulsive therapy (ECT). Upon admission, at 7 AM of the first day of treatment, both the patient and his wife signed a document confirming the observance of preprocedure fasting, a routine in this hospital. A few minutes later, in the ECTroom,whenqueried again about fasting by the ECT nurse, the patient disclosed having eaten a large solid meal earlier in the morning, overreaching the watchfulness of his family. He also stated that by breaking the necessary fast for ECT, he intended to commit suicide, being killed by a compromised anesthetic procedure. His first ECT treatment was then postponed.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125465183","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}

{"title":"Benefits of Deep Transcranial Magnetic Stimulation in Alzheimer Disease: Case Series","authors":"K. Avirame, J. Stehberg, D. Todder","doi":"10.1097/YCT.0000000000000286","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000286","url":null,"abstract":"Background Patients diagnosed with Alzheimer disease (AD) show severe cognitive deficits. Decline in memory, language, and executive function have repeatedly been reported. Although AD affects 60% to 80% of demented elderly patients, there is currently no cure and limited treatment alternatives. Objectives The aim of the study was to evaluate the feasibility of stimulating prefrontal cortex (PFC) with deep transcranial magnetic stimulation (dTMS) to ameliorate cognitive deficits in patients suffering from AD. Methods Eleven patients (6 males; mean [SD] age, 76 [7] years) in moderate to severe stages of AD received dTMS over the PFC for 20 sessions. Computerized battery (Mindstreams [MS]) and neuropsychological testing (Addenbrooke Cognitive Examination [ACE]) were used to assess cognitive performance before and after treatment. Results Compared with baseline, 60% of patients performed better on the MS battery and 77% of patients performed better on the ACE testing at the end of dTMS treatment. None of the patients performed worse on both tests at the end of treatment. The DTMS effects on the group mean in ACE and MS approached significance (P = 0.065 and P = 0.086, respectively). A dTMS-induced improvement in the ACE was significant (P = 0.001) on patients in more progressed stage (n = 6). Change in ACE negatively correlated with score at baseline. Conclusions In sum, the current report of this novel technique indicates that deep stimulation might lead to preservation and even improvement of cognitive functions, at least during the time of treatment. Further examinations should report of long-term effects of this technique.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121395514","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}

{"title":"Mirror-Image Study of Maintenance Electroconvulsive Therapy","authors":"J. Mota, N. Rodrigues-Silva","doi":"10.1097/YCT.0000000000000289","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000289","url":null,"abstract":"Objectives Electroconvulsive therapy (ECT) is a technique with proven efficacy in the treatment of severe psychiatric disorders. However, studies regarding its use as a maintenance therapy are scarce. The aim of the present study was to build knowledge in this area. Methods Data from 28 patients receiving maintenance ECT (M-ECT) were retrospectively collected and analyzed using a mirror-image design. Length of stay and readmissions were compared before M-ECT (control condition) and after M-ECT (experimental condition). Results Our results showed a decrease in both length of stay and number of readmissions after M-ECT, although the decrease in readmissions was moderated by a site effect. Conclusions The present study results reveal the potential benefit of M-ECT. Further studies are urgently needed to establish its usefulness as an alternative treatment for severe psychiatric disorders.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123612760","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}

{"title":"Prolonged Apnea During Modified Electroconvulsive Therapy in a Patient of Suicidal Attempt by Organophosphorus Poisoning: A Case Report.","authors":"Rajesh Dhakne, K. Mishra, Vinay Kumar, P. Khairkar","doi":"10.1097/YCT.0000000000000285","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000285","url":null,"abstract":"Organophosphorus (OP) pesticides are commonly used in agricultural fields to control pests in India. However, exposure to it can cause poisoning in humans and animals, or it can be taken intentionally as poison to commit suicide. We present a case of a 35-year-old suicidal man who developed prolonged apnea for almost 4 hours on day 13 of OP poisoning after brief general anesthesia induced by propofol and 1 mg/kg of suxamethonium, during the first session of the third cycle of modified electroconvulsive therapy, despite all due precautions. Such prolonged apnea secondary to complex interactions has been reported very rarely in literature. This case therefore, highlights the importance of careful evaluation and monitoring while giving anesthesia to OP-poisoning patients.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131182883","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}

{"title":"Repetitive Transcranial Magnetic Stimulation Over Presupplementary Motor Area May Not Be Helpful in Treatment-Refractory Obsessive-Compulsive Disorder: A Case Series","authors":"Aditya Hegde, Malvika Ravi, Subhasini V.S., S. Arumugham, J. Thirthalli, Y. Janardhan Reddy","doi":"10.1097/YCT.0000000000000291","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000291","url":null,"abstract":"Background A significant proportion of patients with obsessive-compulsive disorder (OCD) fail to improve with standard medication and cognitive behavior therapy. Repetitive transcranial magnetic stimulation (rTMS) has been investigated for its role in treating OCD. Low-frequency rTMS over the presupplementary motor area (pre-SMA) has shown mixed results. Moreover, it has not been studied in highly treatment refractory OCD. We analyzed the outcome of low-frequency rTMS over pre-SMA in OCD patients refractory to multiple serotonin reuptake inhibitors (SRIs), augmenting agents, and cognitive behavior therapy. Methods Low-frequency (1-Hz stimulus at 100% motor threshold) rTMS was delivered over the pre-SMA using a previously described protocol. At least 25% reduction Yale-Brown Obsessive Compulsive Scale scores and 2-point reduction in Clinical Global Impression-Severity of Illness scores were used to assess treatment response. Results Seventeen patients were initiated on rTMS. Three of them dropped out within 9 sittings. Only 1 patient met the criteria for response after 1 month of treatment initiation. No major adverse effects were observed in any of them. Limitations The study is a retrospective analysis of outcomes when rTMS was administered as part of routine clinical care. Assessments of the patients were done by trained but different raters, and interrater reliability was not measured. Conclusions Low-frequency rTMS over the pre-SMA may not be effective in treatment refractory OCD. Further studies, taking note of the possible reasons for ineffectiveness discussed in the study, may help elucidate the role of rTMS in OCD.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121834580","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}

{"title":"Catatonia on the Consultation Liaison Service and Other Clinical Settings","authors":"M. Coffey","doi":"10.1097/YCT.0000000000000277","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000277","url":null,"abstract":"C atatonia is a syndrome of motor dysregulation that, once recognized, is gratifyingly treatable with high-dose benzodiazepines and electroconvulsive therapy (ECT). Catatonia occurs in the context of not just several underlying neuropsychiatric disorders but also many general medical disorders. Indeed, 1 review identified catatonia in association with more than 100 general medical disorders. Thus, it comes as no surprise that the diagnosis and management of catatonia are important competencies for the consultation liaison (CL) psychiatrist. One such CL psychiatrist, Brendan Carroll, first described catatonia on the CL service more than 25 years ago. Now, he has teamed up with David Spiegel, another CL psychiatrist, to edit a multiauthored volume dedicated to the topic of catatonia in general medical settings. The 112-page compilation consists of 10 concise chapters, many of which coauthored by one of the editors, as well as a helpful comprehensive index. The main strength of Catatonia on the Consultation Liaison Service and Other Clinical Settings is its up-to-date review of specific neuropsychiatric disorders where catatonia is increasingly recognized. There isawell-organizedchapteroncatatonia inautism spectrum disorders (ASDs) that moves logically from epidemiology and phenomenology to genetics and imaging and finally to treatment. There is another chapter dedicated to Creutzfeld-Jakob disease (CJD), which it takes the form of an extended case report and is less comprehensive than the chapter on catatonia in ASD. And there is an overview chapter that offers a thoughtful approach to thediagnosticworkup for catatonia in general medical settings. The fact that whole chapters are dedicated to ASD and CJD leaves the reader wondering why similar attention is not paid to neuropsychiatric disorders that are encountered on the CL service far more commonly than ASD or CJD. Indeed, the book’s primary opportunity for improvement is to expand substantially the discussions on","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128643753","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}

{"title":"Pregnancy and Electroconvulsive Therapy: A Multidisciplinary Approach","authors":"Shona L. Ray-Griffith, J. Coker, N. Rabie, Lou Ann Eads, K. Golden, Z. Stowe","doi":"10.1097/YCT.0000000000000297","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000297","url":null,"abstract":"Objective To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine these data with a literature review to refine the treatment guidelines for ECT during pregnancy. Methods A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women’s mental health program. Results A total of 8 pregnant women treated with ECT were identified from January 2012 to August 2014. Information was extracted from the medical records of a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range, 1–7). All women were diagnosed as having a mood disorder (either unipolar or bipolar), and 5 of the 8 women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications after the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania after ECT. Obstetrical complications included 2 women with preterm delivery—one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The 5 women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in 6 of the 8 women. Conclusions Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130424493","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}

{"title":"Electroconvulsive Therapy From Both Sides Now: Perspectives From Late and Early Career.","authors":"C. Kellner, E. Li","doi":"10.1097/YCT.0000000000000300","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000300","url":null,"abstract":"I n this editorial, a senior electroconvulsive therapy (ECT) practitioner (C.H.K.) and a fourth-year medical student (E.H.L.) share their perspectives on ECT over the last several decades and now. I (C.H.K.) learned to do ECT as a psychiatric intern at Los Angeles County Hospital in 1978. Although the procedure was basically the same as it is practiced now, there were some notable differences. We, the interns and the psychiatry attending, were the only doctors present; there was no anesthesiologist. We put in the intravenous line, gave the drugs, managed the airway, and did the ECT itself. Not that this was a good thing, but it was testimony to the basic safety of the procedure that the patients all did fine. My experience was the typical one of first-time ECT viewers/participants, that it was “amazing,” “miraculous,” and also that it was really “cool.” Thirty-seven years, hundreds of patients, and many thousands of procedures later, I am happy to say I feel the same way. (Maybe now the descriptor would be “awesome,” instead of “cool.”) Of course, over the years, other things have changed about ECT, both technical and clinical, in addition to the composition of the health care team. Unfortunately, many others have not, notably the stigma and the reluctance, even distaste, among professionals, even within psychiatry, to recommend the treatment. Electroconvulsive therapy, after all these decades, is still struggling to find its rightful place in psychiatric medicine. Some reasons for this struggle are easily understood, some, not so much. As some German ECT colleagues recently stated in an article, “Despite positive scientific evidence, the therapy [ECT] is often approached with reserve that cannot be explained rationally.” The easyto-understand part is the reality of the brutality of original unmodified ECT, and the ubiquity of the barbaric scene from One Flew Over the Cuckoo’s Nest. But it is high time to go beyond the archaic and the fictionalized. The harder part to understand and accept is how the medical and psychiatric establishment has shunned ECT. C. P. Freeman put this into stark perspective 35 years ago in his thenanonymous editorial in Lancet, “ECT in Britain: A Shameful State of Affairs.” Commenting on the results of an audit of ECT services in Great Britain that revealed poor clinical oversight and general shabbiness of ECT suites and equipment, he concluded with the statement, “It is not ECT that has brought psychiatry into disrepute. Psychiatry has done just that for ECT.”Nowadays, things are much better, at least in terms of quality of care delivery in most countries, including Great Britain and the United States: ECT is very well supervised, and it benefits from being included under the rubric of surgical procedures, with all the safeguards of standardized hospital practices, including the addition of an anesthesiologist to the ECT team. Other factors, however, have kept ECT marginalized and raise important questions. Why, for exa","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124001801","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}

{"title":"Changes in Problem-Solving Capacity After a Single Electroconvulsive Treatment.","authors":"A. Scott","doi":"10.1097/YCT.0000000000000296","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000296","url":null,"abstract":"To the Editor: F idalgo et al 1 published the review “Biological markers in noninvasive brain stimulation trials in major depressive disorder: a systematic review,” in which they limited the scope of the review to transcranial magnetic stimulation and transcranial direct current stimulation. By doing so, they imply that electroconvulsive therapy (ECT) is an invasive brain stimulation technique. In medicine, the term invasive typically refers to procedures that breach the integument or require implantation of some device into the body. Electroconvulsive therapy is decidedly a noninvasive procedure, and by far the most effective and evidencebased brain stimulation technique. The incorrect categorization of ECT indirectly promulgated in their article perpetuates the stigmatization of ECT. Contemporary ECT is safe and well tolerated, with cognitive effects typically far less bothersome than ECT of the past. We trust that the title of the systematic review of Fidalgo et al was inadvertently chosen and hope that they agree that ECT is a completely noninvasive technique. Vagus nerve stimulation and deep brain stimulation are invasive, whereas transcranial magnetic stimulation, transcranial direct current stimulation, and ECT are not.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130666647","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}