Convulsive therapy最新文献

{"title":"Different caffeine preparations.","authors":"K G Rasmussen, D D Brink, W H Soine","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"195-6"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837735","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":"The road to practical (and pertinent) bedside memory testing.","authors":"W V McCall","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"136-7"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837840","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":"Completed suicide and recent electroconvulsive therapy in Finland.","authors":"E T Isometsä,&nbsp;M M Henriksson,&nbsp;M E Heikkinen,&nbsp;J K Lönnqvist","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the research phase of the National Suicide Prevention Project in Finland, all completed suicides in Finland (N = 1,397) within a 12-month period were comprehensively examined by using the psychological autopsy method. In this study, we examined the number of cases having received electroconvulsive therapy (ECT) during the 3 final months before suicide. Only two such cases (0.14% of all suicides) were found, a figure remarkably low considering the high prevalence of severe depression in the suicide population. In both of the two cases, the quality of treatment was questionable, and suicide occurred during a depressive relapse. The findings indirectly support earlier reports suggesting ECT to have a preventive effect concerning suicide. However, alternative explanations, such as low base rate of use of ECT in Finland during the study period, or withholding ECT from some patients because of comorbidity, as well as a combined effect of all the three factors, need also to be considered. Among all suicides, those within 3 months after ECT are rare, and the possible efficacy of ECT in preventing suicide warrants further study.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"152-5"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837731","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":"ECT after cerebral aneurysm repair.","authors":"A Farah,&nbsp;W V McCall,&nbsp;R H Amundson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cerebral aneurysms or recent surgical repair of aneurysms are relative contraindications for electroconvulsive therapy (ECT), yet the literature contains at least three cases in which ECT resulted in no known CNS complications. The following case describes a course of ECT in a patient 4 months after he had undergone surgical repair of a posterior cerebral artery aneurysm. Blood pressure control in patients with CNS aneurysms and repaired aneurysms can be achieved through choice of anesthetic agent, and intravenous antihypertensives, thus reducing the risk of cerebrovascular complications.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"165-70"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837733","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":"The cognitive effects of ECT: bridging the gap between research and clinical practice.","authors":"C H Kellner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"133-5"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837839","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":"Exceptionally high seizure threshold: ECT device limitations.","authors":"S H Lisanby,&nbsp;D P Devanand,&nbsp;M S Nobler,&nbsp;J Prudic,&nbsp;L Mullen,&nbsp;H A Sackeim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three patients had exceptionally high seizure threshold, as determined by an empirical titration procedure. Initial seizure threshold was 896 mC in two of the patients. The third patient had an initial threshold of 336 mC that increased to 840 mC at the end of the course of electroconvulsive therapy (ECT), and remained elevated during a second course of ECT. All three patients were elderly men with complicated medical histories and ongoing low-dose benzodiazepine use. Each patient had an excellent response to ECT delivered with a custom modified device, capable of delivering more than twice the charge of ECT devices presently commercially available in the United States. Implications for the administration of ECT in patients with exceptionally high seizure threshold and the limitations of current device output are discussed.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"156-64"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837732","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":"Relationship of seizure morphology to the convulsive threshold.","authors":"W V McCall,&nbsp;G D Robinette,&nbsp;D Hardesty","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Twenty-two patients with major depression received a course of right unilateral ECT. The convulsive threshold (CT) was determined on the first treatment. Subsequent treatments were approximately 2.25 times CT. Seizure morphology for treatments 2-6 were rated for regularity (0-6 scale; low-high) and postictal suppression (0-3; low-high). Ratings of postictal suppression were log transformed to improve the approximation to a normal distribution. A preliminary analysis of variance with CT as the independent variable compared the seizure ratings at low, mid, and high CT. Second, linear regression models for the mean values of seizure regularity and postictal suppression were determined using age, gender, and the CT as predictor variables. The degree of postictal suppression varied inversely with age, male gender, and CT in this study. Our results suggested that CT made the greatest contribution to the model. Future studies examining the predictive value of seizure morphology parameters to clinical outcome should include measurement of CT.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"147-51"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837842","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":"The \"half-age\" stimulation strategy for ECT dosing.","authors":"G Petrides,&nbsp;M Fink","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Energy levels affect the treatment efficacy and efficiency of electroconvulsive therapy (ECT). United States devices require preselection of energy dosage before stimulating patients, and two strategies have been proposed to determine an effective dosage, i.e., based on the patient's age and measured estimates of seizure threshold. The age method is criticized for overstimulation and an assumed association with increased cognitive effects. Threshold determination strategy is cumbersome and requires multiple stimulations, possibly placing patients at increased cardiovascular risk. In 35 patients, we examined an energy estimate for bilateral electrode placement at half the patient's age in \"percent of energy\" or joules delivered by the Thymatron and MECTA devices. Each patient required one stimulation in the first treatment to elicit motor seizures averaging 51.7 s. Subsequently, 20 patients were randomly assigned to either threshold titration followed by half-age for the first two treatments or the opposite (AB-BA design). Half-age energy was 7 J (30%) higher than titration estimates, corresponding to 55% energy of the age method. The relation of half-age and titration estimates were confirmed in energy dosing records from two independent centers. Energy dosing by half-age calculation in bilateral ECT is simple, practical, avoids overdosing and repeat stimulation, and is a useful substitute for the more complex strategy based on threshold estimation.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"138-46"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837841","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":"Experimental studies of the therapeutic action of electroconvulsive therapy in endogenous depression. The role of the electrical stimulation and of the seizure studied by variation of stimulus intensity and modification by lidocaine of seizure discharge.","authors":"B Cronholm,&nbsp;J O Ottosson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three methods of electroconvulsive therapy (ECT) were compared in respect of therapeutic effect in 69 attacks of endogenous depression in 65 patients, not previously treated by ECT during the actual period of illness. The treatments were given under barbiturate narcosis, with full muscular relaxation, administration of oxygen and electroencephalographic recording of the seizure discharge. In two methods grand mal seizures were evoked by supraliminal (A) and liminal stimulation (B), in the third (C) lidocaine (3 mg/kg i.v.) was given before the application of liminal stimulation. The seizure discharges in C were markedly shortened and their pattern modified, while between A and B the duration and pattern of the seizures were similar (Table 1). The patients were referred to the three treatments at random and the groups may be regarded as having a similar prognosis (Table 2-5, 7). The therapeutic outcome was estimated by rating several depressive symptoms according to a rating scale worked out for the purpose. The rating was performed before treatment, one week after the fourth treatment (a treatment pause was then made) and one week after the completed series. To obtain more reliable measures the scores for the various symptoms were added together to form a total score, which was then divided into a depression score and a retardation score, presumably measuring mainly depressive mood and psychomotor retardation. Differences in rating scores on two rating occasions were taken as measures of improvement. In addition, a global rating of improvement was made. The rating procedure was double blind. The principal results were: 1. After four treatments (three patients who recovered after three treatments included) the degree of improvement was in the rank order ABC with significant group differences for a few scores. After the completed series of treatments improvement in groups A and B did not differ significantly whereas in group C it was significantly smaller for some scores (Table 9). 2. The total number of treatments was significantly higher in group C than in group A and B, which did not differ significantly between themselves (Table 10). 3. A measure of therapeutic efficiency, improvement per treatment, was computed by dividing the degree of improvement as obtained from the differences in the combined scores and from the global score of improvement, by the number of treatments. After four treatments the improvement per treatment was highest in group A and lowest in group C, although in the comparisons AB and BC most differences did not reach significance. After the completed series the improvement per treatment did not differ significantly in groups A and B whereas in group C it was significantly less (Table 10). 4. In comparison with groups A and B, the total duration of seizure discharges was significantly shorter in group C both after four treatments and, in spite of the higher number of treatments, after the completed series. The improvem","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 3","pages":"172-94"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19837734","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":"Atrial fibrillation, anticoagulation, and electroconvulsive therapy.","authors":"G Petrides,&nbsp;M Fink","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We describe our experience with six patients with atrial fibrillation (AF) during electroconvulsive therapy (ECT). In four, we observed episodic or persistent conversion of AF to normal sinus rhythm (NSR). Four patients, three with cardioversion and one without, received anticoagulation. In published case reports, ECT was successfully performed in three patients with AF without anticoagulation and in three patients with AF who received anticoagulation. In addition, 18 patients received ECT while taking concomitant anticoagulation therapy for reasons other than AF. Despite the potential risk of embolization with AF, we consider ECT may be safely administered to patients with AF. Because of the high incidence of conversion of AF to NSR, anticoagulation therapy with either warfarin or heparin is recommended.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"12 2","pages":"91-8"},"PeriodicalIF":0.0,"publicationDate":"1996-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19717247","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}