Journal of Ect最新文献

{"title":"Evolution of Electroconvulsive Therapy Practice During the COVID-19 Pandemic: A Systematic Review.","authors":"Josh Martin, Argyrios Perivolaris, Nadeen M Tantash, Ilya Demchenko, Haochen Yu, Zafiris J Daskalakis, Karen Foley, Keyvan Karkouti, Sidney H Kennedy, Akash Goel, Jamie Robertson, Alon Vaisman, David Koczerginski, Benoit H Mulsant, Sagar V Parikh, Daniel M Blumberger, Alastair J Flint, Venkat Bhat","doi":"10.1097/YCT.0000000000001174","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001174","url":null,"abstract":"<p><strong>Abstract: </strong>The COVID-19 pandemic disrupted the provision of electroconvulsive therapy (ECT) across the globe, challenging ECT services to develop protocols that preserve access to this life-saving treatment. This systematic review maps the literature on global ECT practice during the COVID-19 pandemic. The English-language literature was searched through OVID (MEDLINE, PsycINFO, and Embase) on August 7, 2024. Included articles described ECT practice at ECT-providing centers anywhere in the world during the COVID-19 pandemic. Studies were critically appraised, and descriptive synthesis focused on ECT capacity, decision making, hospital resources, procedural modifications, and patient outcomes. Of the 297 identified articles, 61 met the inclusion criteria. In the published articles, 90.7% of articles reported a reduced treatment volume. ECT services were also shifted to prioritize inpatient treatments. Decision making was balanced between administrators and ECT unit staff, although only 2 articles (3.2%) reported the involvement of clinical ethicists in decision making. Other common challenges included staff shortages or redeployment (39.3%), personal protective equipment shortages (18.0%), and limited space availability (11.5%). Among studies that reported on it, relapse occurred in 85.0% articles due to ECT service disruptions. Significant variation in procedural modifications and mitigation strategies were observed, with limited consensus on best practices. To better understand these variations, we developed a decision matrix categorizing ECT service based on the transmission risks and resource availability. This review highlights the importance of evaluating long-term ECT disruptions and developing policies ensuring service continuity in future public health emergencies.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Hypnosis to Alleviate Pain During rTMS: A Case Report.","authors":"Avicenne Bellis, Sofia Charef, Samir Boukhrouf, Noomane Bouaziz, Dominique Januel","doi":"10.1097/YCT.0000000000001175","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001175","url":null,"abstract":"<p><strong>Abstract: </strong>Repetitive transcranial magnetic stimulation (rTMS) is generally well tolerated, with few or no side effects. However, some patients may experience unpleasant sensations such as mild to moderate pain during scalp stimulation. For these patients, any discomfort or pain associated with the procedure may have a negative impact on therapeutic adherence. Hypnosis could offer an interesting option for alleviating pain or discomfort associated with rTMS. We present the case of a patient treated with rTMS, for whom the intensity of stimulation was difficult to tolerate from the first session due to headaches. To alleviate this discomfort, we offered this patient concomitant hypnosis with rTMS. Starting on the third day of the treatment program, Ericksonian hypnosis was carried out over the remaining 7 days, with self-hypnosis gradually replacing the therapist's intervention. Hypnosis was conducted 5 minutes before the start of the stimulation sessions. Visual analog scales were used to assess pain and anxiety, before and during rTMS sessions. The visual analog scale score dropped from 8.5 to 3 for pain and from 5 to 3 for anxiety before and during a session. Stimulation intensity, initially reduced due to pain felt by the patient, was increased back to its original level. Combining hypnosis with rTMS not only reduced the patient's perception of pain, but also improved her tolerance to the intensity of stimulation, enabling her to complete the treatment program in greater comfort. Beyond pain management, hypnosis could also have a potentiating effect on rTMS.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legislation Limiting Access to Electroconvulsive Therapy Is Increasing-A Call for Reasonable and Evidence-Based Legislation.","authors":"Emily M Beydler, Lauren M Katzell, Joseph Dragonetti, Nicholas Ortiz","doi":"10.1097/YCT.0000000000001173","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001173","url":null,"abstract":"<p><strong>Introduction: </strong>There is an increasing body of legislation that limits access to electroconvulsive therapy (ECT) with a relative lack of directives and recommendations from psychiatrists regarding these laws.</p><p><strong>Methods: </strong>The authors utilized LexisNexis to examine newer legislation related to various aspects of ECT and the implications of these laws in ECT treatment.</p><p><strong>Results: </strong>These laws include regulations regarding informed consent, age restrictions, and approved practitioners. All but one of these enacted laws are restrictive.</p><p><strong>Discussion: </strong>Such laws reduce the availability of this life-saving treatment for patients, with little to no base in medical evidence, and in some cases, clear inaccuracies written by lawmakers with no medical training. This is a call for advocacy for laws to be based on medical facts to protect and reduce mortality for some of our most vulnerable patients.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroconvulsive Therapy for Self-injurious Behavior in Autism Spectrum Disorders: Case Series.","authors":"Nam Young Lee, In Won Chung, Lee Elizabeth Wachtel, Yong Sik Kim","doi":"10.1097/YCT.0000000000001172","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001172","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report Highlights Vigilance for Electroconvulsive Therapy Preprocedural Fasting.","authors":"Osama Bhatti, David Athan, Louise Dawson","doi":"10.1097/YCT.0000000000001163","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001163","url":null,"abstract":"<p><strong>Abstract: </strong>This case report describes an instance of aspiration in a 50-year-old male who surreptitiously broke his fast before his second Electroconvulsive therapy despite multiple fasting confirmations and strict food security measures, leading to subsequent necessitating intensive care unit management. Although not confirmed, there was high suspicion of intentional sabotage. This case highlights the importance of ensuring fasting compliance in psychiatric patients and encourages clinicians to practice vigilance in patients who may be considered high risk and falsify fasting adherence.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended High Definition Transcranial Direct Current Stimulus for Improvement in Cognitive Functions as Measured by Sensorimotor Network Alterations in Chronic Schizophrenia: A Resting State fMRI Study.","authors":"Bhawna Yadav, Nishant Goyal, Chandramouli Roy, Dharani Ramamoorthy","doi":"10.1097/YCT.0000000000001158","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001158","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive symptoms form core of schizophrenia affecting interpersonal and socio-occupational functioning. Impaired dorsolateral prefrontal cortex function is implicated in these symptoms. Dysfunction in sensory-motor network (SMN) has been attributed to cognitive dysfunction in schizophrenia. High-definition tDCS (HD-tDCS), an optimized form of tDCS, has the potential for more focalized neuromodulation. Extended HD-tDCS (eHD-tDCS), that is, more than 10 sessions over an extended period of time, may increase the effectiveness of stimulation.</p><p><strong>Objectives: </strong>We aimed to study the effects of eHD-tDCS on SMN alterations for improvement in cognitive functions in chronic schizophrenia.</p><p><strong>Methods: </strong>Fifty-one patients of chronic schizophrenia (>2-year continuous illness) with predominantly cognitive symptoms were enrolled for this sham-controlled trial. Participants received 20 sessions of eHD-tDCS at 2 mA for 20 minutes twice daily over 10 days. Montreal Cognitive Assessment Scale and Clinical Global Impression-Severity Scale and Resting State f MRI (rsfMRI) were used to assess outcome. Clinical assessments were carried out at baseline, 2 weeks, and 6 weeks and rsfMRI at baseline and 2 weeks.</p><p><strong>Results: </strong>Significant improvement was noted in both active and sham groups across all outcome variables over time. However, a statistically significant decrease in cognitive symptoms and illness severity in active group was noted at the end of treatment at 2 weeks, maintained till the end of 6 weeks. After application of eHD-tDCS, a significant improvement in functional connectivity was noted in SMN. The novel extended stimulation protocol was safe and well tolerated.</p><p><strong>Conclusions: </strong>Extended HD-tDCS emerges to have a substantial potential in the treatment of cognitive symptoms and it is safe and well tolerated.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New-Onset Atrial Fibrillation After Electroconvulsive Therapy: A Case Report and Clinical Implications.","authors":"Maria Miguel Amaral Dos Santos Figueiredo, Pedro Miguel Azevedo Afonso","doi":"10.1097/YCT.0000000000001169","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001169","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe, Repeated Treatment With Electroconvulsive Therapy in Combination With KarXT.","authors":"Jason M Andrus, Sohag N Sanghani","doi":"10.1097/YCT.0000000000001168","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001168","url":null,"abstract":"<p><strong>Abstract: </strong>To our knowledge, no report has been made of safe concurrent treatment with the novel muscarinic antipsychotic agent KarXT and electroconvulsive therapy (ECT). The drug has the potential for influencing the ECT procedure as well as outcomes. These issues are explored in the context of a case in which KarXT and ECT were successfully combined safely and repeatedly.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relative Efficacy and Side-Effect Profile of Ultrabrief Pulse and Brief Pulse ECT: A Systematic Review of Recent Literature.","authors":"Rishi Gonuguntla, Sam Dunham, Isaac Benmaman, Neha Gonuguntla, Kevin Ha","doi":"10.1097/YCT.0000000000001164","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001164","url":null,"abstract":"<p><strong>Objective: </strong>Electroconvulsive therapy (ECT) is an interventional psychiatric technique used primarily to address treatment resistant psychiatric disorders. There are many different stimulus electrode placements and pulse widths utilized in the administration of this therapy, but it is presently unclear which is optimal. The aim of this study is to assess the relative efficacy and side-effect profile of ultrabrief pulse width ECT (UBP ECT) and brief-pulse width ECT (BP ECT) in the treatment of major depressive disorders.</p><p><strong>Method: </strong>A systematic review of the literature was performed. Studies were identified from PubMed, MEDLINE and PsycINFO between January 2013 to October 2023. The final search terms included ECT, depression, brief pulse, and ultrabrief pulse.</p><p><strong>Results: </strong>The search initially included 64 studies. Forty-three of these studies were not duplicates, after applying exclusion criteria 11 studies were included. UBP ECT was found to have fewer cognitive side effects than BP ECT. Additionally, patients undergoing BP ECT were found to discontinue treatment more frequently due to inability to tolerate side effects. Despite this, BP ECT may have higher rates of symptom remission than UBP ECT. Further studies should be done to clarify the outcomes of each technique.</p><p><strong>Conclusions: </strong>The current evidence slightly favors UBP ECT due to its beneficial side effect profile compared to BP ECT while it has a similar efficacy. However, there is insubstantial evidence in the current body of literature. Additional studies are required to determine which of these techniques is safer and more efficacious in the treatment of major depressive disorders.</p><p><strong>Study design: </strong>Systematic review.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Dose Flumazenil and Caffeine to Facilitate Electroconvulsive Therapy in Malignant Catatonia.","authors":"Mark Volpe, Dallas Hamlin, Emma Batchelder, Charles Mormando, Andrew Francis","doi":"10.1097/YCT.0000000000001165","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001165","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}