Journal of Ect最新文献

{"title":"Improvement in Quality of Seizures in Electroconvulsive Therapy With Zotepine: A Case Report.","authors":"Teruyuki Matsuoka, Nobutaka Ayani, Sumihiro Yamano","doi":"10.1097/YCT.0000000000001112","DOIUrl":"10.1097/YCT.0000000000001112","url":null,"abstract":"<p><strong>Abstract: </strong>Regular symmetric high-amplitude seizure waves, postictal suppression, constant seizure duration, and sympathetic nervous system excitation are used to evaluate the efficacy of electroconvulsive therapy (ECT) for seizures. Seizure quality is rated from 0 to 3 (higher scores indicate better quality) using seizure quality categories (SQC). We report a case in which zotepine (ZTP) improved seizure quality. A woman in her 50s developed schizophrenia in 1993. In December 2021, her delusions, anxiety, and agitation worsened, and she was admitted to our hospital. ECT was started in November 2022 but discontinued after 10 sessions because of the patient's refusal. However, her agitation became more noticeable, and she was placed in isolation in December 2022. ECT was resumed in March 2023 and accompanied by risperidone (RIS) 4 mg, with SQC scores of 1-2 points for sessions 1-8. A gradual change from RIS to ZTP began at session 9, and RIS was discontinued by session 17. The SQC was 2 points with ZTP dose of 150 mg. The SQC improved to 3 points during sessions 21-23 after ZTP dose was increased to 300 mg. The electroencephalogram showed improvement, especially in regular symmetric high-amplitude seizure waves and postictal suppression during sessions 21-23. ECT was terminated in September 2023 (after 27 sessions in total) when the patient was mentally ready to be released from isolation. This case indicates that ZTP may improve the quality of ECT-induced seizures.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e35-e37"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124134","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 Electroconvulsive Therapy in Posttraumatic Stress Disorder: A Systematic Review.","authors":"Laura Callens, Pascal Sienaert","doi":"10.1097/YCT.0000000000001063","DOIUrl":"10.1097/YCT.0000000000001063","url":null,"abstract":"<p><strong>Abstract: </strong>Posttraumatic stress disorder (PTSD) is associated with a high burden of disability and mortality. Despite standard treatments with antidepressants and/or psychotherapy, remission is often difficult to achieve. Electroconvulsive therapy (ECT) is an effective treatment for mood disorders but is currently not recognized as a treatment modality for PTSD. The literature about its potential role in the management of PTSD is growing. Thus, we aim to systematically review the available evidence for the role of ECT in PTSD.Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines, we performed a systematic literature search from 1958 to December 2023 using PubMed, Embase, Web of Science, Cochrane Central Register of Controlled trials databases, and the Clinicaltrials.gov-registry .Eighteen studies met our inclusion criteria: 1 meta-analysis, 2 randomized control trials, 2 prospective, 4 retrospective studies, 8 case reports, and 2 reviews.Accumulating evidence suggests that ECT might have a beneficial effect on the core symptoms of PTSD with comorbid conditions, such as depression or schizophrenia. Although in some studies, the effect on core PTSD symptoms was not related to an antidepressant effect of ECT, these findings need further replication. Nevertheless, in severe and intractable cases, ECT can be considered, especially in the presence of comorbid depression. Further research in patients without comorbidity is warranted.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"155-160"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044204","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":"Individual on Death Row Receiving Electroconvulsive Therapy (ECT) for Catatonia: A Case Report.","authors":"Brian J Basden, Sandarsh Surya, Peter B Rosenquist, William V McCall","doi":"10.1097/YCT.0000000000001082","DOIUrl":"10.1097/YCT.0000000000001082","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) is underused, logistically challenging for those who are justice-involved, and laced with ethical problems for those on death row. Herein we describe a case of a man without history of long-standing psychiatric illness who, after more than 15 years on death row, was hospitalized for altered mental status. After medical stabilization, the altered mental status persisted. On exam, he displayed signs of catatonic stupor with repetitive non-goal-directed motor activity, repetition of words, rigidity, and negativism, among others. The Bush-Francis Catatonia Rating Scale was found to be 23. Lorazepam was nontherapeutic. Hospital psychiatry considered ECT. Hospital medicine, medical prison staff, and the hospital ethics committee were consulted. Consent to treat catatonia with ECT was obtained from next of kin. Before treatment, the ECT psychiatrist spoke with prison staff regarding the presence of plastic restraints. To balance the competing demands of carceral policies and musculoskeletal protection, we implemented the practice of removing plastic restraints after the patient was sedated by anesthetic, with restraints being reapplied after the motor convulsion ended. Five days after 7 ECT treatments given thrice weekly, the catatonic symptoms remitted. Ethically, psychiatrists are not to restore competency for the purpose of execution. In this case, ECT was used by psychiatrists unaffiliated with the criminal legal system to reduce suffering and improve quality of life given the potentially fatal consequences of catatonia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"215-217"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016673","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":"Self-Rated ECT Outcomes in Patients With Depression: A Naturalistic Single-Site Study.","authors":"Shane R Berger, Simon Kung, Maria I Lapid","doi":"10.1097/YCT.0000000000001081","DOIUrl":"10.1097/YCT.0000000000001081","url":null,"abstract":"<p><strong>Objectives: </strong>Electroconvulsive therapy (ECT) is considered to be the most effective treatment for severe depression. This study investigated recent ECT outcomes for depression at a large tertiary center, which also provides community care.</p><p><strong>Methods: </strong>Data were obtained from Mayo Clinic Rochester patients ages 18 and older who received an acute course of ECT between August 1, 2017 and April 30, 2024. Patients were included if there was a depressive disorder diagnosis (unipolar or bipolar) and a self-rated Patient Health Questionnaire-9 (PHQ-9) within 10 days of the start and end of the acute course. Patients were excluded if the starting PHQ-9 score was less than 10. The age, sex, number of acute course treatments, stimulus electrode lead placement, and PHQ-9 scores were collected. Response (PHQ-9 improvement ≥50%) and remission (PHQ-9 < 5) rates were calculated. Linear and logistic regressions were performed to investigate predictors of response and remission.</p><p><strong>Results: </strong>Of 1206 patients identified, 408 met final inclusion and exclusion criteria. The response rate was 80.4%, and remission rate was 52.7%. Logistic regression for response showed no significant predictors; the P value for age just missed statistical significance (odds ratio, 1.0152; 95% confidence interval, 0.9991-1.0316; P = 0.0641). Logistic regression for remission showed only a lower baseline PHQ-9 score (odds ratio, 0.9465; 95% confidence interval, 0.9049-0.9891; P = 0.0152) as a significant predictor.</p><p><strong>Conclusions: </strong>Our results affirmed the high efficacy of ECT in severe depression. No other established treatment for depression can report a response rate as high as 80% in a naturalistic study. This study supports the continued relevance and place of ECT for severe depression.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"183-187"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632952","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":"Emergency Treatment of Neuroleptic Malignant Syndrome By a Remote Mobile Electroconvulsive Therapy (ECT) Team.","authors":"Clément Guillet, Francky T Endomba, Mehdi Benkhadra","doi":"10.1097/YCT.0000000000001179","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001179","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978939","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":"Trends and Age-Stratified Analysis of Electroconvulsive Therapy Utilization in Japan: A Nationwide Population-Based Cohort Study Between 2014 and 2021.","authors":"Masamitsu Kido, Anri Watanabe, Takashi Nakamae, Katsutoshi Shoda, Jin Narumoto","doi":"10.1097/YCT.0000000000001182","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001182","url":null,"abstract":"<p><strong>Objectives: </strong>The status of electroconvulsive therapy (ECT) in Japan is unknown on a nationwide scale. This study aims to elucidate the use of ECT utilizing a Japanese nationwide receipt database.</p><p><strong>Methods: </strong>The annual average number of ECT sessions per 100,000 people in Japan between 2014 and 2021 was evaluated by stratifying the population into sex and age groups. ECT was further broken down into management type (outpatient or inpatient) and anesthesia methodology (general or non-general). We analyzed the distribution peak patterns of the age-stratified data. Annual trends were evaluated using the Jonckheere-Terpstra trend test or Poisson regression model.</p><p><strong>Results: </strong>Over the 8-year period, the overall ECT administration amounted to 700,621 sessions, translating to a rate of 69.2 sessions per 100,000 person-years. The men-to-women ratio was 1:1.4, indicating slight women predominance. The age-stratified data fluctuated greatly from year to year, except for inpatient ECT under general anesthesia (iECT-GA), which remained stable. Peak analysis of the iECT-GA indicated that the maximum peak was observed in men aged 50 to 59 years and women aged 70 to 74 years.</p><p><strong>Conclusions: </strong>Considering that a typical ECT course consists of 6 to 12 sessions, the average number of patients undergoing ECT is estimated to be 5.8 to 11.5 per 100,000 person-years. A demographic peak of the iECT-GA was observed in men in their 50s and early 70s for women, suggesting distinct sex-specific patterns. This preliminary study provides an overview of the ECT use in Japan, representing one of the nations in Asia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979061","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":"Evaluating the Effects of Electroconvulsive Therapy on Cognitive Functions in Patients With Severe Mental Health Conditions: A Prospective Study.","authors":"Asif Abrar Mohammed Najeeb, Mohammed Qutishat, Rima Ikhlaq, Ikhlaq Ahmed, Salim Al-Huseini","doi":"10.1097/YCT.0000000000001185","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001185","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is increasingly recognized as an effective treatment for severe mental disorders, particularly in cases that do not respond to conventional therapies. However, concerns about its cognitive side effects remain common among patients and clinicians. This study aims to assess, evaluate, and compare cognitive functions in psychiatric patients with severe mental health conditions before and following ECT administration.</p><p><strong>Method: </strong>This is a prospective study involving 36 patients diagnosed with severe mental disorders who received electroconvulsive therapy (ECT). Cognitive assessments were conducted before treatment, immediately after treatment, and 1 week after the final session. Paired t tests were used to analyze the data and evaluate changes in cognitive performance.</p><p><strong>Results: </strong>The findings revealed a mild but statistically significant decline in specific cognitive functions such as memory (an average decrease of 15%) and attention (an average decline of 10%). Notably, cognitive performance showed signs of recovery within a week, with 75% of patients reporting enhanced overall cognitive clarity.</p><p><strong>Conclusions: </strong>ECT continues to be a powerful therapeutic option for severe mental disorders accompanied by manageable cognitive side effects. Monitoring and support are crucial for optimizing patient outcomes and promoting long-term recovery strategies.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978923","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":"Ictal Asystole During ECT.","authors":"Caleb Pozdnikoff, Jake Johnston, Foroogh Najafi, Elizabeth Gregory, Rana Hamidizadeh, Chantelle Hrazdil, Matthias Görges, Fidel Vila-Rodriguez","doi":"10.1097/YCT.0000000000001178","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001178","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979033","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":"Precision High Definition-Transcranial Direct Current Stimulation (HD-tDCS) for Sensory Perceptual Deficits in Childhood Disintegrative Disorder: A Case Study.","authors":"Sarnava Hazra, Shivani Gusain, Nishant Goyal, Pooja Daga","doi":"10.1097/YCT.0000000000001170","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001170","url":null,"abstract":"<p><strong>Abstract: </strong>High-definition transcranial direct current stimulation (HD-tDCS) offers targeted neuromodulation for neurological disorders. This case study reports its use in a 10-year-old boy with childhood disintegrative disorder and sensory hyposensitivity. After localizing deficits using auditory steady-state response with a Geodesic Transcranial Electrical Neuromodulation system, 20 HD-tDCS sessions were delivered to the left primary auditory cortex over 10 days. After treatment, Autism Treatment Evaluation Checklist scores showed a 66% improvement, with sensory gains in auditory (26%) and proprioceptive (50%) domains, sustained at 1-month, 3-month and 6-month follow-ups. The intervention was well-tolerated with no adverse effects, demonstrating HD-tDCS's potential as a viable treatment for sensory deficits in childhood disintegrative disorder.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546235","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":"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}