Journal of Ect最新文献

{"title":"Living With Electroconvulsive Therapy-A Qualitative Study of the Subjective Experiences of Patients Having Continuation or Maintenance Electroconvulsive Therapy.","authors":"Prashanth Mayur, Nyan Du, Anthony Harris, Venkat Ramakrishnan, Jagadeesh Andepalli, Beatriz López-Portillo","doi":"10.1097/YCT.0000000000001310","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001310","url":null,"abstract":"<p><strong>Objective: </strong>To explore the subjective experience of patients receiving continuation/maintenance electroconvulsive therapy (C/M-ECT) for severe, recurrent mental illnesses, addressing a literature gap in this unique cohort whose perspective remains unexplored.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted on 10 voluntary adult patients (aged 32 to 66 y) from outpatient C/M-ECT services in Western Sydney Local Health District and St John of God Richmond Hospital, Sydney, Australia. Participants, primarily with major depressive episodes due to treatment-resistant unipolar depression or bipolar disorder, completed semistructured interviews (60 to 90 min) starting with an open-ended narrative prompt. Interviews were audio-recorded, transcribed, and analyzed thematically, with themes refined iteratively through consensus discussions.</p><p><strong>Results: </strong>Thematic analysis revealed 5 themes: clinical (C/M-ECT was seen as a life-saving last resort, stabilizing symptoms after failed treatments. Cognitive side effects were heterogeneous, ranging from minimal to pervasive, though mitigated by adaptive strategies. Ultimately, benefits were seen to outweigh drawbacks); access (logistical/financial barriers); staff (trust through long-term relationships and expertise); family (vital support amid ambivalence due to concerns of side effects); and fear/stigma (initial fears diminishing with experience, though stigma prompted selective disclosure).</p><p><strong>Conclusion: </strong>This qualitative study on voluntary patients of long-term ECT for depression universally described its life-changing value in keeping them well and out of hospitals for long periods. Even though subjective cognitive effects were frequently reported, they were viewed as adaptable and an acceptable trade-off. The study also highlighted concerns of barriers to access ECT and the presence of support, with concerns about the length of treatment/number of ECTs from family.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801825","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":"Recognizing Dermatitis Artefacta in Acute Psychotic Relapse: Clinical Resolution Following Electroconvulsive Therapy.","authors":"Rashmi Shukla, Mansi Ranga","doi":"10.1097/YCT.0000000000001308","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001308","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763565","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":"Management and Prevention of Tardive Seizures: A Protocol and Case Series From Clinical Experience at Yale Psychiatric Hospital.","authors":"Rachel Katz, Anthony Tanella, Robert Ostroff","doi":"10.1097/YCT.0000000000001281","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001281","url":null,"abstract":"<p><p>Tardive seizures are a rare but serious complication of electroconvulsive therapy, which can lead to early termination of an ECT course. A recent review by Warren et al discussed the reported prevalence of and risk factors for these events. While uncommon, our experience at Yale Psychiatric Hospital has revealed that tardive seizures occur more frequently than historically described, requiring urgent treatment for seizure termination and adjustments to subsequent ECT treatments. In our experience, most patients can safely continue ECT without further tardive seizures if appropriate adjustments are made. To our knowledge, there is no standardized algorithm for the management of tardive seizures, nor an explicit set of guidelines for risk mitigation if ECT will be continued. We provide both based on the data for management of status epilepticus, guided by our clinical experience and focused on short-acting agents appropriate for an ECT PACU setting. We also provide recommendations about when ECT should be paused and further workup pursued.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521586","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 Catatonia in Primary Brain Calcification: A Case Report.","authors":"Shun Igarashi, Taichi Nakakoji, Fumiko Kusunoki Nakamoto, Koichiro Kumagai, Shuho Namatame, Megumi Kubota, Daisuke Hayashi, Takamasa Noda, Shinsuke Kito","doi":"10.1097/YCT.0000000000001300","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001300","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551144","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":"Pulmonary Aspiration During Electroconvulsive Therapy in a Patient on Multiple Psychotropic Medications: A Case Report and Risk-Stratified Approach to Preprocedural Gastric Ultrasound.","authors":"Vikas Chauhan, Ikya Muppuri, Allen C Richert, Lakshmi N Kurnutala","doi":"10.1097/YCT.0000000000001303","DOIUrl":"10.1097/YCT.0000000000001303","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is usually performed under general anesthesia using a sedative-hypnotic and a short-acting neuromuscular blocker, typically without instrumentation of the airway. We report a case of pulmonary aspiration during ECT in a 27-year-old man on multiple psychotropic medications who was fully compliant with standard American Society of Anesthesiologists (ASA) preoperative fasting (Nil per Os, NPO) guidelines. A postprocedure point-of-care (POC) gastric ultrasound revealed a full stomach with solid contents. The cumulative anticholinergic burden of his medication regimen, including clozapine, benztropine, quetiapine, paliperidone, and prazosin, combined with the recognized association between psychiatric illness and disordered gastric motility, likely contributed to retained gastric contents at the time of induction. We review the limitations of fasting-based risk assessment, the prevalence of residual gastric content in appropriately fasted patients, the evidence supporting POC gastric ultrasound as a decision-support tool, and the practical constraints of equipment availability and operator training. We propose a risk-stratified approach in which preprocedural POC gastric ultrasound is recommended for ECT patients with one or more risk factors for delayed gastric emptying-rather than as a universal, mandatory examination.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450303","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":"Pulse Width Effects on Electroconvulsive Therapy.","authors":"Conrad M Swartz","doi":"10.1097/YCT.0000000000001302","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001302","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450249","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":"Remission, Relapse, and Rapid Re-Response With Accelerated Transcranial Direct Current Stimulation (tDCS) in Obsessive-Compulsive Disorder: Longitudinal Course With Implications for Durability and Maintenance Strategies.","authors":"Swarndeep Singh, Palak Sunilkumar Patel, Amit Kumar Yadav, Pankaj Verma","doi":"10.1097/YCT.0000000000001289","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001289","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426543","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":"Successful Use of Electroconvulsive Therapy in Treatment-Resistant Catatonia With Comorbid Parkinson Disease and Neuroborreliosis: A Case Report.","authors":"Nicolas Eden, Darius Zokai, Daniel Lüdecke, Nils Freundlieb, Niklas Schade","doi":"10.1097/YCT.0000000000001297","DOIUrl":"10.1097/YCT.0000000000001297","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is a highly effective intervention for treatment-resistant catatonia and severe neuropsychiatric disorders. We present the case of a 67-year-old patient with a long-standing diagnosis of schizophrenia who developed catatonic symptoms in the context of Parkinson disease (PD) and neuroborreliosis. After a medication switch from risperidone to quetiapine the patient rapidly deteriorated, displaying psychotic symptoms, disorganized behavior, and aggression. Multiple pharmacological interventions, including clozapine, high-dose risperidone, and benzodiazepines, were ineffective despite therapeutic plasma levels. The patient required seclusion over 50 times due to persistent agitation. Subsequently, he became increasingly withdrawn, refusing food and fluids, and developed pronounced catatonic features (mutism, echopraxia). After 3 months of unsuccessful pharmacotherapy, bilateral ECT was initiated. Within 6 sessions, the patient showed marked clinical improvement. A total of 18 ECT sessions led to full remission of catatonic and psychotic symptoms, with no further need for coercive measures. The patient was discharged home and continues to receive maintenance ECT. This case highlights the efficacy of ECT in managing complex catatonic states in patients with comorbid neuropsychiatric and neuroinflammatory conditions. It also emphasizes the importance of early ECT consideration when pharmacological approaches fail in multifactorial clinical scenarios.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354709","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 Movement Disorders: A Systematic Review.","authors":"Louis Kindts, Kyra Bouillon, Pascal Sienaert","doi":"10.1097/YCT.0000000000001225","DOIUrl":"10.1097/YCT.0000000000001225","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is an established treatment strategy for a range of psychiatric disorders, including depression, mania, psychosis, and catatonia. A growing body of evidence suggests that ECT may affect motor symptoms in movement disorders. In a systematic review, we aim to review the evidence on the use of ECT in movement disorders. We searched PubMed, SCOPUS, Cochrane, Web of Science, and Embase to identify relevant publications. Fifty-eight papers were retained for data extraction. The existing evidence suggests a beneficial impact of ECT on both motor and nonmotor symptoms across various movement disorders, with the most substantial findings reported for Parkinson disease. Conversely, the evidence pertaining to Huntington disease and related disorders cannot rule out a potentially negative effect. Given that the data reviewed are constrained in both quantitative and qualitative rigor, predominantly derived from case reports, further research through the publication of case reports and the conduct of standardized clinical trials is warranted.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297372","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":"Comparison of Electroconvulsive Therapy Seizure Outcomes When Using Methohexital Versus Propofol: A Brief Retrospective Report.","authors":"Yousief Fahd, Mervin Blair, Bahareh Kheiri, Lili Meng, Melissa Quaye, Richard O'Reilly, Amer M Burhan","doi":"10.1097/YCT.0000000000001301","DOIUrl":"10.1097/YCT.0000000000001301","url":null,"abstract":"<p><strong>Objectives: </strong>To compare seizure parameters and treatment burden between methohexital and propofol during routine electroconvulsive therapy (ECT), focusing on seizure duration, treatment efficiency, and missed seizures.</p><p><strong>Methods: </strong>This retrospective chart review examined differences in seizure outcomes between 2 commonly used agents, methohexital and propofol, at the Parkwood Institute from October 2017 to October 2019.</p><p><strong>Results: </strong>A total of 132 adult patients were included: 47 received methohexital (mean age 60.9±15.4; 44.7% male) and 85 received propofol (mean age 55.1±17.1; 35.3% male). No significant demographic differences were observed. Methohexital was associated with longer motor (35.6±19.7 vs. 23.4±11.7 s; P <0.001) and EEG (50.8±28 vs. 36.8±19.2 s; P =0.003) seizure durations. It was also directly associated with a higher number of total ECT treatments (13±6.5 vs. 11±5.3; β=0.29, P <0.001), though the raw difference was only marginally significant ( P =0.08). Missed seizures were slightly fewer with methohexital (1.9±2.9 vs. 2.4±2.1; P =0.251). Multilevel structural equation modelling revealed a statistically significant indirect pathway through which methohexital influenced treatment continuity (Estimate = -0.743, P =0.044, standardized β=-0.061), mediated through motor seizure slope and missed seizures.</p><p><strong>Conclusions: </strong>While methohexital may initially enhance seizure quality, its decline in efficacy over time may compromise treatment efficiency. These findings suggest methohexital's initial seizure advantages may be offset by declining seizure duration across treatments and its downstream association with missed seizures. These findings may inform more efficient ECT anesthetic choices.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260745","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}