Journal of Ect最新文献

{"title":"Sociodemographic Patterns of Electroconvulsive Therapy Referral and Utilization in a Tertiary Health Care Facility.","authors":"Adeolu Funso Oladunjoye, Syed Murtaza, Isabel Draper, Robin Livingston","doi":"10.1097/YCT.0000000000001134","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001134","url":null,"abstract":"<p><strong>Objective: </strong>Despite electroconvulsive therapy's (ECT) proven effectiveness in various psychiatric conditions, ECT referral and utilization remains suboptimal. This study sought to examine the pattern of ECT referral and utilization at a tertiary care center and to assess factors contributing to the underutilization of ECT.</p><p><strong>Methods: </strong>This retrospective study examined patients referred to ECT at this facility from 2022-2023 (N = 76, ≥18 y/o) with demographic data obtained from the electronic medical record.</p><p><strong>Results: </strong>Seventy-six patients were referred for ECT, with 35 receiving treatments. The treated group had a slightly younger mean age (45.5 vs 46.2 years). Gender distribution varied, with more males receiving ECT (54.3%) and more females declining (70.7%). Whites were the majority in both groups, but Blacks were less likely to receive ECT (14 not treated vs 4 treated), while Hispanics were more likely to be treated (2 not treated vs 7 treated). Declining ECT was more frequent among Whites (61.9%) and Blacks (33.3%), while transportation and logistical issues affected various racial groups with the highest impact on Blacks (42.9%). Major depressive disorder was the primary diagnosis, evenly distributed between treated and nontreated patients. In comparison to state data, Blacks and Asians showed a higher representation among the treatment group with those treated with ECT, 11.4% versus 6.7% and 5.7% versus 3.5%, respectively.</p><p><strong>Conclusions: </strong>ECT remains underutilized among minority racial/ethnic groups. Factors contributing to this pattern include referral, patient preference, and/or other specific situations that need to be addressed to reduce disparities.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765983","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 in Cochlear Implant Users.","authors":"Thomas James Crotty, Anwar Alshehri, Adrien Gendre, Fergal Glynn, Peter Walshe","doi":"10.1097/YCT.0000000000001138","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001138","url":null,"abstract":"<p><strong>Introduction: </strong>Cochlear implant manufacturers currently contraindicate the use of electroconvulsive therapy (ECT) in CI users, citing theoretical evidence of potential harm to the patient or the implant despite a lack of clinical data. We report two uncomplicated cases of ECT in CI users, including the first reported case of bilateral ECT in a patient with bilateral CIs.</p><p><strong>Case series: </strong>The first case involves a 66-year-old visually impaired male with bilateral CIs. He suffered from major depressive disorder complicated by refusal of oral intake despite maximal pharmacological therapy. He underwent 9 consecutive cycles of bilateral ECT, after which his psychiatric condition improved. Cochlear implant function remained unchanged following the procedure. The second case involved a 65-year-old female with a left-sided CI and a history of recurrent depressive disorder. Her condition deteriorated with the onset of auditory hallucinations and increased suicidality. She underwent 8 consecutive cycles of unilateral ECT with right-sided electrode placement. Her psychiatric condition improved, and there was no change in CI impedance following the procedure.</p><p><strong>Conclusions: </strong>We report 2 successful cases of ECT in CI users, including the first reported case of bilateral ECT in a patient with bilateral cochlear implants. Further investigation into the safety of ECT in CI users is warranted to ensure that this crucial treatment modality remains available to this vulnerable patient cohort.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712193","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":"\"His Discovery Has Revolutionized Psychiatry; It Has Opened Vast Horizons\": Ugo Cerletti, a Missing Nobel Prize Laureate?","authors":"Elisabetta Sirgiovanni, Nils Hansson","doi":"10.1097/YCT.0000000000001136","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001136","url":null,"abstract":"<p><strong>Abstract: </strong>Drawing on original sources from Italian and Swedish archives, this article provides novel insights into the life of Ugo Cerletti (1877-1963). Cerletti, the Italian neuropsychiatrist and originator (with his assistant Lucio Bini) of electroconvulsive therapy (ECT) in the late 1930s, strongly coveted the Nobel Prize in the 1950s and 1960s. He would never receive it, despite maintaining close correspondence with his nominators and informants in Sweden. This article critically discusses potential reasons for the rejection of his candidacy, including the tensions between Cerletti and Bini and the general climate of suspicion against ECT that began in the 1960s, and draws comparisons with other missing Nobel laureates. The research herein adds previously unknown details to the history of ECT; it will be shown that Cerletti was opposed by some members of the Nobel committee even before popular anti-ECT attacks and that his attempts to remedy this situation were unsuccessful.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659237","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":"Implementing Electroconvulsive Therapy for Patients Experiencing Behavioral and Psychological Symptoms of Dementia: A Systematic Review.","authors":"Aditya Nidumolu, Daniel Kapustin, Tarek Benzouak, Sanjay Rao, Sameh Hassan, Shabbir Amanullah","doi":"10.1097/YCT.0000000000001125","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001125","url":null,"abstract":"<p><strong>Objectives: </strong>Electroconvulsive therapy (ECT) has long been used to treat behavioral and psychological symptoms of dementia (BPSD). However, there are no guidelines for the use of ECT in this population. Contributing to efforts addressing this gap in the literature, this qualitative systematic review examines areas of consensus and disagreement in currently published protocols for the use of ECT in BPSD.</p><p><strong>Methods: </strong>MEDLINE and PsychInfo were searched for primary and secondary literature meeting the aim of this review. All articles were screened, full-text reviewed, and extracted in duplicate. A framework synthesis methodology was used to identify key steps in conducting ECT for BPSD.</p><p><strong>Results: </strong>Thirty-two studies were included in this systematic review. Although these studies converged on similar indications for using ECT in BPSD, there was significant heterogeneity in the stimulus characteristics used and approaches to maintenance treatment.</p><p><strong>Conclusions: </strong>ECT holds promise in the treatment of BPSD. Although further research is needed to establish optimal treatment parameters, this review can be used by clinicians to identify potential approaches to using ECT.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652026","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":"Translation and Critical Evaluation of the Columbia University Autobiographical Memory Interview-Short Form for use in the Dutch Language.","authors":"Chioma Nwatarali, Esmée Verwijk, Dominique Blokland, Isidoor O Bergfeld","doi":"10.1097/YCT.0000000000001098","DOIUrl":"10.1097/YCT.0000000000001098","url":null,"abstract":"<p><strong>Introduction: </strong>Assessment of autobiographical memory following electroconvulsive therapy is lacking multilingual options. We therefore developed the Dutch translation of the Columbia University Autobiographical Memory Interview-Short Form (CUAMI-SF). We aimed to assess its practical use and identify segments for potential revision to improve the interview's applicability.</p><p><strong>Methods: </strong>The CUAMI-SF comprises 30 questions asking details about 6 segments (eg, last trip, last birthday) and 7 question categories (eg, dates, list of persons present). The interview was translated to Dutch using blind back-translation principles. We evaluated practicality and potential redundancy, through surveying a focus group and quantitative analyses of 60 participants, including depressed patients treated with electroconvulsive therapy (n = 14) or deep brain stimulation (n = 25) and healthy controls (n = 21). For the quantitative analyses, we compared the average percentage of nonanswered questions at baseline between groups. The average consistency scores after a follow-up of approximately 6 weeks were also calculated and compared for each segment between the groups.</p><p><strong>Results: </strong>The focus group mostly found the CUAMI-SF easy to use and to score, but argued redundancy in specific questions asking for dates, numbers, and addresses. The largest differences in consistency scores between the groups were present for the segments \"travel,\" \"birthdays,\" \"New Year's Eve,\" and \"doctor's visits,\" indicating higher sensitivity compared with \"family member\" and \"job.\"</p><p><strong>Discussion: </strong>The CUAMI-SF was found easy to use by administrators. The segments \"family member\" and \"job\" emerged as less sensitive. Therefore, removal might maintain sensitivity while reducing administration time, which could prove beneficial in clinical and research settings.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803424","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":"Letter to the Editor: Recurring Use of Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in ECT.","authors":"Tanmai Bandarupalli, Larry H Kuhn","doi":"10.1097/YCT.0000000000001137","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001137","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631082","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":"Efficacy of Adjunctive High-Frequency Deep Transcranial Magnetic Stimulation for Improving Negative Symptoms in Schizophrenia: A Feasibility Study.","authors":"Gulesh Kumar, Nishant Goyal, Aniruddha Mukherjee, Pooja Sharma, Dharani Ramamoorthy","doi":"10.1097/YCT.0000000000001124","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001124","url":null,"abstract":"<p><strong>Background: </strong>Negative symptoms of schizophrenia are disabling and respond inadequately to antipsychotic treatment. Hypofunctioning of cortical areas such as anterior cingulate cortex and medial prefrontal cortex has been implicated in negative symptoms. Repetitive transcranial magnetic stimulation is efficacious for the negative symptoms. Deep transcranial magnetic stimulation (dTMS) has the benefits of repetitive transcranial magnetic stimulation with the advantage of stimulating deeper brain targets.</p><p><strong>Objective: </strong>The aim of the study was to explore the efficacy of high-frequency dTMS for improving negative symptoms in schizophrenia.</p><p><strong>Methods: </strong>This was a sham-controlled, rater, and subject-blinded study. Forty-six patients were randomly assigned into active and sham groups. Ten sessions of high-frequency dTMS at 10 Hz were given at 100% of resting motor threshold using H7 coil over 2 weeks. The Positive and Negative Syndrome Scale, Scale for Assessment of Negative Symptoms, and Clinical Global Impressions were assessed at baseline, at 2 weeks, and at 4 weeks after completion of dTMS.</p><p><strong>Result: </strong>Forty-three patients completed the study. Although both active and sham groups shown improvement over the time, active dTMS group showed significant improvement in negative symptoms as indicated by significant improvement in the Scale for Assessment of Negative Symptoms score as compared to sham dTMS group (P = 0.003, η2 = 0.158), further substantiated by improvement in negative subscale of Positive and Negative Syndrome Scale (P = 0.044, η2 = 0.079).</p><p><strong>Discussion: </strong>Findings from our study suggest that adjunctive high-frequency dTMS significantly improves negative symptoms and severity of illness among patients with schizophrenia. Future studies with larger sample sizes will add our knowledge in the beneficial effects of this newer modality of noninvasive brain stimulation.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631080","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":"Safety and Efficacy of Continuous Theta Burst \"Intensive\" Posterior Parietal Cortex Stimulation in Generalized Anxiety Disorder: A Randomized Double-Blind Sham-Controlled Trial.","authors":"Sarthak Bhandari, Mohan Dhyani, Shobit Garg, Sai Krishna Tikka","doi":"10.1097/YCT.0000000000001131","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001131","url":null,"abstract":"<p><strong>Objectives: </strong>Citing nonresponse to conventional treatments, neuromodulation based treatments are needed in generalized anxiety disorder (GAD). Data regarding continuous TBS (cTBS) in GAD has been anecdotal. Citing right posterior parietal cortex (PPC) hyperconnectivity in GAD, we aimed to study the effect of intensive cTBS targeting PPC in a randomized rater-blinded placebo-control design.</p><p><strong>Material and methods: </strong>Forty-four patients age range 18-59 years (baseline Hamilton Anxiety Rating Scale [HAM-A] score >18 or Clinical Global Impression Severity [CGI-S] score of ≥4) were randomly allocated to active cTBS (n = 22) and sham cTBS (n = 22) groups using block randomization method. They received 10 cTBS sessions, 2 sessions per day (total of 1200 pulses) for 5 days in a week at 80% motor threshold. HAM-A, World Health Organization's abbreviated quality of life assessment (WHOQOL-BREF), and CGI-S were assessed at baseline, after the last session, and at 2 weeks after cTBS with gender as covariate. Intention-to-treat analysis was conducted and missing values were replaced using the last observation carried forward method.</p><p><strong>Results: </strong>On repeated measures analysis of variance, a significant between-group time effect for HAM-A (F = 29.6; P = 0.001; ηp2 = 0.420), CGI-S (F = 24.7; P = 0.001; ηp2 = 0.376), and WHOQOL-BREF (F = 29.6; P = 0.001; ηp2 = 0.420). Logs of odds of response of >50% improvement in HAM-A between active and sham groups is 3.27 (95% CI [0.345, 6.20]). No major side effects were reported and none discontinued the trial because of side effects.</p><p><strong>Conclusions: </strong>Our trial concludes that cTBS of posterior parietal cortex is safe, well-tolerated, and effective in GAD.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631084","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 Role of Brain Derived Neurotrophic Factor Polymorphism in Transcranial Magnetic Stimulation Response for Major Depressive Disorder.","authors":"Megan M Vigne, Jamie Kweon, Andrew M Fukuda, Joshua C Brown, Linda L Carpenter","doi":"10.1097/YCT.0000000000001123","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001123","url":null,"abstract":"<p><strong>Objectives: </strong>Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective therapy for treatment-resistant depression (TRD). A crucial next step in improving rTMS therapy is to identify response predictors to inform patient selection criteria. Brain-derived neurotrophic factor (BDNF) exerts influence over TRD treatment modalities. BDNF polymorphism, Val66Met, has shown altered cortical plasticity after single-session rTMS in healthy subjects and clinical response in noninvasive brain stimulation methods in major depressive disorder, stroke, Alzheimer's, and cerebral palsy. We sought to evaluate the effect of this BDNF polymorphism on clinical response in a standard course of rTMS therapy for TRD.</p><p><strong>Methods: </strong>In this naturalistic study, 75 patients with TRD completed a standard course of rTMS with weekly clinical assessments via the Inventory of Depressive Symptomatology Self-Report (IDS-SR). BDNF polymorphisms were retrospectively compared in respect to treatment response and remission, baseline and final scores, percent change scores, and scores across the 6-week treatment course.</p><p><strong>Results: </strong>As expected, rTMS significantly decreased depressive symptoms as measured by IDS-SR scores. No difference was found in baseline, final, or percent change IDS-SR scores between polymorphism types. There was no difference between polymorphisms in IDS-SR scores across the treatment course. Response and remission rates did not differ between genotypes.</p><p><strong>Conclusions: </strong>In contrast to previous research highlighting differential response between BDNF polymorphisms to motor plasticity and clinical rTMS outcomes, our data suggest that BDNF polymorphism status may not influence the response to a standard course of 10-Hz rTMS for major depressive disorder. Differences in TMS protocol, target, or BDNF serum levels may underlie our results.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558796","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":"Revitalizing Lost Memories: Long-Term Swift Learning and Improvement Post Electroconvulsive Therapy: A Case Report.","authors":"Clara Massaneda-Tuneu, Colleen Loo, Donel Martin","doi":"10.1097/YCT.0000000000001116","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001116","url":null,"abstract":"<p><strong>Abstract: </strong>Although there is robust evidence of electroconvulsive therapy's (ECT's) efficacy in severe mental illnesses, its use is still constrained by patients' and clinicians' concern about the possibility of cognitive side effects. It is established that anterograde amnesia usually recovers within weeks of the acute ECT treatment course, whereas retrograde memory loss can persist in the long term in some patients. To date, it remains unknown whether retrograde memory loss after ECT can recover and, if so, how.This case report describes a patient who received an acute course of bifrontal 0.5 milliseconds ECT within a time frame of 6 months. The patient initially experienced significant memory loss, including anterograde and retrograde amnesia, the latter including knowledge and skills learnt from more than a decade prior to ECT. During the first year after the patient received ECT, her anterograde memory functioning recovered, but her retrograde memory loss remained. Notably, 2 years after the last ECT treatment, the patient observed an ability to rapidly relearn the material and skills that were lost after ECT. We believe that this case report will offer hope for patients who experience longer-term retrograde memory loss after ECT and stimulate new research on novel interventions for post ECT amnesia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558794","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}