The Journal of ECT最新文献

{"title":"Subjective Memory Immediately Following Electroconvulsive Therapy","authors":"O. Brus, P. Nordanskog, U. Båve, Yang Cao, Å. Hammar, M. Landén, J. Lundberg, A. Nordenskjöld","doi":"10.1097/YCT.0000000000000377","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000377","url":null,"abstract":"Objectives The aims of the present study were to describe the short-term rate of subjective memory worsening (SMW) and identify factors of importance for SMW in a large clinical sample treated for depression with electroconvulsive therapy (ECT). Methods This register-based study included 1212 patients from the Swedish National Quality Register for ECT. Subjective memory worsening was defined as a 2-point worsening on the memory item of the Comprehensive Psychopathological Rating Scale from before to within 1 week after treatment. Associations between patient characteristics and treatment factors were examined using logistic regression. Results Subjective memory worsening was experienced in 26%. It was more common in women than in men (31% vs 18%; P < 0.001) and more common in patients aged 18 to 39 years than in patients 65 years or older (32% vs 22%; P = 0.008). Patients with less subjective memory disturbances before ECT had a greater risk of SMW. Patients in remission after ECT had a lower risk of SMW. A brief pulse width stimulus gave higher risk of SMW compared with ultrabrief pulse (odds ratio, 1.61; 95% confidence interval, 1.05–2.47). Conclusions Subjective memory worsening is reported by a minority of patients. However, young women are at risk of experiencing SMW. Ultrabrief pulse width stimulus could be considered for patients treated with unilateral electrode placement who experience SMW. Each patient should be monitored with regard to symptoms and adverse effects, and treatment should be adjusted on an individual basis to maximize the clinical effect and with efforts to minimize the cognitive adverse effects.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"266 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133314350","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":"Alcohol Use Disorder as a Possible Predictor of Electroconvulsive Therapy Response","authors":"S. Aksay, M. Hambsch, C. Janke, J. Bumb, L. Kranaster, A. Sartorius","doi":"10.1097/YCT.0000000000000366","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000366","url":null,"abstract":"Introduction Two rapidly acting antidepressive treatment forms, namely, electroconvulsive therapy (ECT) and ketamine, possibly share a common mechanism of action primarily involving alterations of neurotransmission (glutamate and &ggr;-aminobutyric acid levels). Because patients receiving ketamine and with a coexistent family history of an alcohol use disorder (AUD) seem to benefit from consistent and longer lasting antidepressive effects, we hypothesized better treatment response in ECT patients with an own history or a family history of an AUD. Method One hundred forty-one psychiatric inpatients with a major depressive episode, who were treated with ECT, were enrolled into this retrospective study. Age, sex, family or personal history of alcohol or benzodiazepine use disorder, ECT response data, and ECT treatment-related data were collected and analyzed with ordinal logistic regression and Fisher exact tests. Results Twenty-one percent of all patients had their own history of an AUD, 11% had their own history of a benzodiazepine use disorder, and 11% reported on a positive family history of alcohol or benzodiazepine use disorder. The logistic regression analyses revealed that only patient's own history of an AUD predicts a better ECT response (P = 0.031; odds ratio, 2.1; Fisher exact test, P = 0.006). Conclusions Within the limitations of a retrospective study, a history of an AUD seems to be a positive predictor for an ECT response in patients experiencing a major depressive episode, which has not been found in 2 earlier studies. Findings are in line with neurobiological hypotheses of excitatory/inhibitory neurotransmitter changes with ketamine and ECT.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133667588","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":"A Meta-review of the Safety of Electroconvulsive Therapy in Pregnancy","authors":"Preeti Sinha, P. Goyal, C. Andrade","doi":"10.1097/YCT.0000000000000362","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000362","url":null,"abstract":"Background Four systematic reviews have examined the safety of electroconvulsive therapy (ECT) in pregnancy. These have varied widely in methods, findings, and conclusions. Methods We compared these reviews with regard to search strategy, study selection criteria, total number of studies identified, total number of patients included, findings related to safety and adverse events, and interpretation of results. Results The number of studies (number of cases) included in the reviews ranged from 16 (n = 300) to 67 (n = 169) with only one review stating reasons for exclusion of nonselected studies. We provide comparisons about how the reviews described patient characteristics, illness characteristics, ECT characteristics, confounder characteristics, and outcome characteristics; there was wide variation in these regards. We list adverse outcomes that were identified by some but not other reviews. We provide a detailed breakdown of the adverse maternal and fetal outcomes identified in each review. Finally, we examine how different reviews interpreted their findings; whereas some reviews provided reasons for ruling out ECT as an explanation for an adverse outcome, one review adopted the stance that all adverse outcomes were potentially ECT-related. Conclusions Our meta-review provides readers with comparative information on the strengths and limitations of the 4 systematic reviews, their findings, and their conclusions. It can assist with clinical decision making on the use of ECT in pregnancy by providing a more complete description of the available literature.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132039425","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":"A Camptocormia Case Treated With Electroconvulsive Therapy.","authors":"Huseyin Bayazıt, F. Kılıçaslan, Kadir Guler, I. Karababa, H. Kandemir","doi":"10.1097/YCT.0000000000000355","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000355","url":null,"abstract":"To the Editor: C amptocormia is defined as an abnormal posture involving thoracolumbar flexion of trunk that increases during standing and disappears during recumbent position. First observed in young soldiers during WorldWar I and II, it was initially considered as hysteria. It has been described in association with many diseases or conditions, particularly in Parkinson disease. We presented resolution of camptocormia with electroconvulsive therapy (ECT) in a patient with bipolar disorder.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134180827","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":"Effect of Low Dose of Ketamine on Learning Memory Function in Patients Undergoing Electroconvulsive Therapy—A Randomized, Double-Blind, Controlled Clinical Study","authors":"Qibin Chen, S. Min, Xuechao Hao, Lihua Peng, H. Meng, Q. Luo, Jianmei Chen, Xiao Li","doi":"10.1097/YCT.0000000000000365","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000365","url":null,"abstract":"Objectives Converging evidence suggests that low doses of ketamine have antidepressant effects. The feasibility and safety of administering low doses of ketamine as adjunctive medication during electroconvulsive therapy (ECT) to enhance ECT efficacy and mitigate cognitive impairment has attracted much attention. This study investigated the effects of low doses of ketamine on learning and memory in patients undergoing ECT under propofol anesthesia. Methods This randomized, placebo-controlled, double-blind study recruited patients with moderate to severe depressive disorders who failed to respond to antidepressants and were scheduled to receive ECT. Participants were randomly assigned to a study group, which received an intravenous administration of 0.3 mg/kg ketamine and then underwent ECT under propofol anesthesia, and a control group, which received isovolumetric placebo (normal saline) and then underwent ECT under propofol anesthesia. The Hamilton Depression Rating Scale was used to assess the severity of depression after ECT. Before and after the ECT course, the Mini-mental State Examination and the Wechsler Memory Scale-Chinese-Revision were used to assess global cognitive and learning and memory functions, respectively. Psychotropic effects were assessed using the Brief Psychiatric Rating Scale. Vital signs and other adverse events were recorded for each ECT procedure. Results Of 132 patients recruited, 66 were assigned to each group; 63 patients in study groups and 64 patients in the control group completed the ECT course during the study. Afterward, the incidence of global cognitive impairment in the control group was higher than it was in the study group. In addition, the decline in the Wechsler Memory Scale-Chinese-Revision scale was greater in the control group than in the study group. The necessary ECT treatment times were shorter in the study group than in the control group (8 [7, 9] vs 9 [8, 10]). No significant escalations of the positive Brief Psychiatric Rating Scale scores or adverse events were observed in the study group when compared with the control group. Conclusions As adjunctive medication, ketamine can attenuate learning and memory impairment, especially for short-term memory, caused by ECT performed under propofol anesthesia. Ketamine can also reduce ECT treatment times during the therapy course without inducing significant adverse effects.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130732576","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 in Schizophrenia in China: A National Survey","authors":"Qian Li, Yun-Ai Su, Y. Xiang, L. Shu, Xin Yu, G. Ungvari, S. Seiner, H. Chiu, Yuping Ning, Gao-Hua Wang, Kerang Zhang, Tao Li, Li-Zhong Sun, Jian-guo Shi, Xian-Sheng Chen, Q. Mei, Ke-Qing Li, T. Si","doi":"10.1097/YCT.0000000000000361","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000361","url":null,"abstract":"Objective Little is known about electroconvulsive therapy (ECT) use in the treatment of schizophrenia in China. This study examined the frequency of ECT use, its trend between 2006 and 2012, and its independent demographic and clinical correlates in a nationwide survey in China. Methods A total of 5162 inpatients in 45 Chinese psychiatric hospitals/centers were interviewed (2696 in 2006 and 2466 in 2012). Patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Results Electroconvulsive therapy was used in 6.1% of the whole sample; 4.7% in 2006 and 7.7% in 2012 (P < 0.001) with wide interprovince variations. Multiple logistic regression analyses of the whole sample revealed that patients receiving ECT were more likely to be women, receive second-generation antipsychotics, treated in tertiary referral centers (level III hospitals), had a shorter illness duration, and more positive and depressive symptoms (R2 = 0.181; P < 0.001). Conclusions Electroconvulsive therapy for schizophrenia has increased between 2006 and 2012 in China. Its percentage was higher than the figures reported in most other countries. Reasons for the substantial variations in the frequency of ECT across different provinces in China require further investigations.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125810689","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":"Electroshock as Means for Social Control","authors":"M. Fink","doi":"10.1097/YCT.0000000000000403","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000403","url":null,"abstract":"144 fter more than 80 years of clinical experience, electroconvulsive therapy A (ECT)—the induction of grand mal seizures as treatments of severely ill patients with psychiatric disorders—continues to raise strong emotions with doubts of its efficacy and fears of its adverse effects. To these criticisms, Jonathan Sadowsky, Professor of Medical History at Cleveland's Case Western Reserve University sees the treatment as a means of social control. He comes to this subject with prior writing on the history of madness treated in Nigeria in the colonial era. He begins by quoting the “whee” of Sylvia Plath and the failure of her first course of treatment. A recurrence was successfully treated. In the history of trials of electricity in medicine, the induction of seizures using electric currents was developed in fascist Rome in 1938 by Professor Ugo Cerletti as replacements for those induced by chemicals in Budapest 4 years earlier by Ladislas Meduna. The first electric inductions were remarkably facile and safe to apply, and the technique was quickly brought to America by prewar European émigrés. By 1941, 42% of American psychiatric hospitals had ECT machines. Although Sadowsky doffs his hat to the treatments' usefulness in relieving severely depressed, manic and psychotic patients, he focuses his interest on its social impacts. In his third chapter, he considers “ECT has been used as a mechanism of social control: 1) ECTas a tool for maintaining order and hierarchy on the wards of mental hospitals; 2) ECTas a tool for gender conformity, and 3) ECTas a tool for the enforcement of sexual norms.” The enthusiasm aroused by the successful and quick treatment of long-term hospitalized psychiatric ill is compared with the publicly praised limited benefits of psychoanalysis. The conflicts encouraged public anti-ECT movements in the","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130733821","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":"Effects of Transcranial Magnetic Stimulation on the Cognitive Control of Emotion: Potential Antidepressant Mechanisms.","authors":"C. Lantrip, F. Gunning, L. Flashman, R. Roth, P. Holtzheimer","doi":"10.1097/YCT.0000000000000386","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000386","url":null,"abstract":"Depression negatively impacts quality of life and is associated with high mortality rates. Recent research has demonstrated that improvement in depression symptoms with transcranial magnetic stimulation (TMS) to the dorsolateral prefrontal cortex (DLPFC) may involve changes in the cognitive control network, a regulatory system modulating the function of cognitive and emotional systems, composed of the DLPFC, dorsal anterior cingulate, and posterior parietal cortices. Transcranial magnetic stimulation to the DLPFC node of the cognitive control network may have antidepressant efficacy via direct effects on cognitive control processes involved in emotion regulation. This review provides a review of the impact of TMS on cognitive control processes, especially those related to emotion regulation, and posits that these effects are critical to the mechanism of action of TMS for depression. Treatment implications and future directions for study are discussed.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125327712","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":"Spontaneous Seizure From Remifentanil Induction During Electroconvulsive Therapy.","authors":"C. Kellner, M. Çiçek, Kate G. Farber, W. Reiss, Christopher R. Cowart","doi":"10.1097/YCT.0000000000000392","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000392","url":null,"abstract":"temperature change, studies have demonstrated the energy used in ECT to be too low to cause significant heating of metallic plates, especially titanium (the material used in most neurosurgical implants at this time), which is principally inert. In addition, given the exponential fall in total energy with increasing distance, lead placement that maximizes distance from the intracranial objects further decreases theoretical risk of heat and current shunting. We therefore suggest that in patients with intracranial objects and comorbid seizure disorders, antiepileptics should be safely minimized to limit energy delivered and intracranial objects be clearly located to optimally adjust lead placement. Although there have been previously published cases of successful ECT treatment with intracranial metallic objects and comorbid epilepsy, this is the first, to our knowledge, to document safe treatment with ECTwith titanium mesh in the posterior fossa.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130748955","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":"Cognitive Performance Under Electroconvulsive Therapy (ECT) in ECT-Naive Treatment-Resistant Patients With Major Depressive Disorder","authors":"Christoph Ziegelmayer, G. Hajak, A. Bauer, M. Held, R. Rupprecht, W. Trapp","doi":"10.1097/YCT.0000000000000385","DOIUrl":"https://doi.org/10.1097/YCT.0000000000000385","url":null,"abstract":"Objectives Although electroconvulsive therapy (ECT) is considered a safe and highly effective treatment option for major depressive disorder, there are still some reservations with regard to possible adverse cognitive adverse effects. This is the case despite a large body of evidence showing that these deficits are transient and that there even seems to be a long-term improvement of cognitive functioning level. However, most data concerning cognitive adverse effects stem from studies using mixed samples of treatment-resistant and non–treatment-resistant as well as ECT-naive and non–ECT-naive subjects. Furthermore, neurocognitive measures might partly be sensitive to practice effects and improvements in depressive symptom level. Methods We examined neurocognitive performance in a sample of 20 treatment-resistant and ECT-naive subjects using repeatable neurocognitive tests, whereas changes in depressive symptom level were controlled. Cognitive functioning level was assessed before (baseline), 1 week, and 6 months (follow-up 1 and 2) after (12 to) 15 sessions of unilateral ECT treatment. Results No adverse cognitive effects were observed in any of the cognitive domains examined. Instead, a significant improvement in verbal working memory performance was found from baseline to follow-up 2. When changes in depressive symptom levels were controlled statistically, this improvement was no longer seen. Conclusions Although findings that ECT does not lead to longer lasting cognitive deficits caused by ECT were confirmed, our study adds evidence that previous results of a beneficial effect of ECT on cognition might be questioned.","PeriodicalId":287576,"journal":{"name":"The Journal of ECT","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132960021","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}