M E Leatherman, R D Ekstrom, M E Tancer, R N Golden
{"title":"The impact of an electroconvulsive therapy consultation service on ECT use at a university teaching hospital.","authors":"M E Leatherman, R D Ekstrom, M E Tancer, R N Golden","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In order to test the hypothesis that the establishment of a centralized electroconvulsive therapy (ECT) consultation service would affect ECT use at a university teaching hospital, we retrospectively reviewed medical records of patients who received ECT during two 12-month periods preceding and following the institution of a comprehensive ECT consultation service. Data regarding ECT usage, including utilization, types of patients treated, and lengths of stay, were obtained. Patients treated after the institution of a comprehensive ECT consultation service received ECT with less delay, were discharged more quickly after the conclusion of ECT treatment, and had shorter lengths of stay compared with patients who received treatment before the initiation of the service. Following the establishment of the ECT service, the absolute number of patients who received ECT increased, although the rate of ECT use did not change. These findings suggest that the establishment of a comprehensive ECT consultation service may lead to more efficient use of this important treatment in university hospitals and to more cost-effective treatment of some patients with major depression. Additional research is necessary to explore the generalizability of these findings to other treatment settings.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"253-9"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19884450","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}
D C Steffens, A D Krystal, T E Sibert, S D Moore, R D Weiner
{"title":"Cost effectiveness of maintenance ECT.","authors":"D C Steffens, A D Krystal, T E Sibert, S D Moore, R D Weiner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"283-4"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19883719","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":"An unusual effect of ECT on drug-induced parkinsonism and tardive dystonia.","authors":"B Hanin, Y Lerner, N Srour","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A patient with schizoaffective disorder and anticholinergic refractory neuroleptic-induced parkinsonism manifested a marked increase of parkinsonian symptoms and dystonia after ECT. This is the first report in the literature of such an unusual reaction of parkinsonian and dystonic symptoms to ECT.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"271-4"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19883716","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 and the media.","authors":"S J Kantor","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"284-6"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19883720","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":"Use of ECT in a patient with a Harrington rod implant.","authors":"A T Hanretta, P Malek-Ahmadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 50-year-old depressed patient with prior Harrington rod implantation and spinal disease was treated with 6 electroconvulsive therapy (ECT) treatments, despite conflicting orthopedic recommendations. Complete muscle relaxation was achieved with succinylcholine 2.1-2.2 mg/kg without complication during or after ECT. Concerns and recommendations regarding the use of ECT in patients with Harrington rods are discussed.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"266-70"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19884455","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":"Subjective side effects during electroconvulsive therapy.","authors":"D P Devanand, L Fitzsimons, J Prudic, H A Sackeim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 92 depressed patients who were randomized to unilateral or bilateral electroconvulsive therapy (ECT) at either low dosage (just above seizure threshold) or high dosage (2.5 times the seizure threshold), subjective side effects were assessed with the Columbia ECT Subjective Side Effects Schedule. A research nurse administered the instrument 4 h after each treatment during the ECT course. In 41 patients, the instrument was also administered before the ECT course. Headache, disorientation, and memory complaints were the most common subjective side effects during the ECT course. Somatic side effects did not change from early to late in the ECT course, and were not influenced by ECT electrode placement or dosage. Most individual somatic side effects, including nausea, tiredness, and muscle aches/pains did not change from pre-ECT to during the ECT course, and may have been a function of the persistent somatic symptoms of depression. Cognitive complaints increased from pre-ECT to during the ECT course, but there was no overall change from pre-ECT to immediately after the ECT course. Cognitive complaints were greater with bilateral compared with unilateral ECT, with no significant effect of electrical dosage. During the ECT course, subjective mood improved and psychomotor agitation decreased, particularly in clinical responders. These findings suggest that most putative somatic side effects are related to the depressive state rather than being induced by ECT. The observed changes reinforce the need to evaluate both subjective and objective side effects during ECT.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"232-40"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19884446","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":"Professor Bini's notes on the first electro-shock experiment.","authors":"L Bini","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"260-1"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19884452","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":"Can we teach psychiatric residents to rate seizure regularity?","authors":"W V McCall, A Farah, D M Reboussin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite recent advances in electroconvulsive therapy, clinicians still lack a reliable marker of treatment adequacy. Electroencephalographic (EEG) seizure morphology has been proposed as such a marker. However, the reliability of seizure ratings has not been assessed. We present the results of a study that examined how readily psychiatric residents could be taught to rate seizure morphology using a seizure regularity scale. We found that trainees could reliably rate seizure regularity and were particularly adept at discerning highly regular seizures from irregular ones. We believe that establishing reliable human scoring for electroconvulsive therapy seizure regularity justifies the position that human inspection of the ictal EEG should always complement computer analyses of seizure morphology.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"248-52"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19884448","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 2 weeks post coronary artery bypass graft surgery.","authors":"J P Riesenman, M R Scanlan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case of a depressed patient who received a full course of electroconvulsive therapy (ECT) 2 weeks post four-vessel coronary artery bypass graft surgery (CABG). ECT was well tolerated, and a full remission was induced. In spite of the lack of information in the literature concerning guidelines for administering ECT to a patient with recent postoperative status, we were encouraged by this patient's response. This case suggests that ECT may be considered a viable treatment option for refractory depression associated with severe medical comorbidity and recent post-operative status such as in CABG.</p>","PeriodicalId":79333,"journal":{"name":"Convulsive therapy","volume":"11 4","pages":"262-5"},"PeriodicalIF":0.0,"publicationDate":"1995-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19884454","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}