Electroconvulsive Therapy in Sweden

1979 ◽  
Vol 134 (3) ◽  
pp. 283-287 ◽  
Author(s):  
Svend-Otto Frederiksen ◽  
Giacomo D'Elia
Keyword(s):  
General Anaesthesia ◽  
Electroconvulsive Therapy ◽  
Affective Disorders ◽  
Psychiatric Treatment ◽  
Muscle Relaxants ◽  
Confusional States

SummaryIn spite of a decrease in the number of electroconvulsive treatments (ECT) administered during the decade 1966–1975, ECT is still commonly used in Sweden. About 4 per cent of all patients admitted for psychiatric treatment during 1975 received ECT. Affective disorders and confusional states appear to be the main indications. Treatment is usually unilateral, with general anaesthesia and muscle relaxants, generally using the same type of ECT machine.

When should ECT be used?

1977 ◽  
Vol 15 (1) ◽  
pp. 2-4
Keyword(s):  
Electroconvulsive Therapy ◽  
Mode Of Action ◽  
Depressive Illness ◽  
Muscle Relaxants ◽  
House Of Commons ◽  
Mode Of Administration ◽  
Lay People ◽  
Harmful Effects

Though electroconvulsive therapy (ECT) has been widely used in depressive illness for over 30 years, its use is empirical, its mode of action remains unknown, and some medical and lay people have asserted that its dangers outweigh its usefulness. Over the years the mode of administration has gradually changed with the introduction of anaesthetics and muscle relaxants. The number of shocks in a course of ECT has tended to lessen and unilateral ECT has some advantages.1 Nevertheless, recently the long-standing controversy on its use has increased. In some states in America legislation has been introduced to restrict it2 and questions on its possible harmful effects have been asked in the House of Commons.3

Long-Term Risk of Developing Dementia After Electroconvulsive Therapy for Affective Disorders

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Simon Hjerrild ◽  
Johnny Kahlert ◽  
Poul-Erik Buchholtz ◽  
Raben Rosenberg ◽  
Poul Videbech
Keyword(s):  
Electroconvulsive Therapy ◽  
Affective Disorders

scholarly journals Unexpected cancellation on a catatonic patient’s electroconvulsive therapy due to the coronavirus pandemic

2020 ◽  
Vol 33 (6) ◽  
pp. e100271
Author(s):  
Kelsey Casano ◽  
Erin Capone
Keyword(s):  
Electroconvulsive Therapy ◽  
Psychiatric Treatment ◽  
Orotracheal Intubation ◽  
Treatment Team ◽  
Dependent Personality Disorder ◽  
Making A Difference ◽  
Positive Treatment ◽  
History Of ◽  
Novel Coronavirus ◽  
Bag Mask Ventilation

We report a case of a 39-year-old woman with a psychiatric history of schizoaffective disorder with catatonia, dependent personality disorder and substance use disorder whose symptoms have been very difficult to control. During her most recent inpatient admission, she was treated with electroconvulsive therapy (ECT) for catatonia. Our treatment team was hopeful that ECT was making a difference for this patient. However, she was only able to receive two sessions of treatment due to new hospital protocols related to the coronavirus pandemic. Although the patient was not suspected to have the coronavirus, she could no longer undergo ventilation with a bag and mask during the procedure. Bag–mask ventilation is known to aerosolise the coronavirus and other diseases and potentially put healthcare workers at risk. Although orotracheal intubation also aerosolises the coronavirus, this was the only means of airway management still allowed by anaesthesia providers at this time. Our psychiatry team estimated that the risks of intubation outweighed the benefits of treatment, and ECT was cancelled.Without additional ECT treatments, the patient again decompensated for several weeks before being stabilised on clozapine, haloperidol and lorazepam. Although she eventually had a positive treatment outcome, her hospital course was likely prolonged due to unforeseen events related to the novel coronavirus. We feel that the current medical climate is unprecedented and is interfering with necessary psychiatric treatment in an unanticipated way. Anaesthesiologists will need to be flexible while working with psychiatrists and identify safe ways to provide this necessary psychiatric treatment for patients.

Anaesthesia and neuromuscular disorders: what a neurologist needs to know

2020 ◽  
pp. practneurol-2020-002633
Author(s):  
Luuk R van den Bersselaar ◽  
Marc M J Snoeck ◽  
Madelief Gubbels ◽  
Sheila Riazi ◽  
Erik-Jan Kamsteeg ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Neuromuscular Disorders ◽  
Muscle Relaxants ◽  
Rich Domain ◽  
Specific Advice ◽  
Voltage Dependent ◽  
Life Threatening ◽  
Ryanodine Receptor 1 ◽  
Domain 3 ◽  
Cysteine Rich Domain

Neurologists are often asked for specific advice regarding patients with neuromuscular disease who require general anaesthesia. However, guidelines on specific neuromuscular disorders do not usually include specific guidelines or pragmatic advice regarding (regional and/or general) anaesthesia or procedural sedation. Furthermore, the medical literature on this subject is mostly limited to publications in anaesthesiology journals. We therefore summarise general recommendations and specific advice for anaesthesia in different neuromuscular disorders to provide a comprehensive and accessible overview of the knowledge on this topic essential for clinical neurologists. A preoperative multidisciplinary approach involving anaesthesiologists, cardiologists, chest physicians, surgeons and neurologists is crucial. Depolarising muscle relaxants (succinylcholine) should be avoided at all times. The dose of non-depolarising muscle relaxants must be reduced and their effect monitored. Patients with specific mutations in RYR1 (ryanodine receptor 1) and less frequently in CACNA1S (calcium channel, voltage-dependent, L type, alpha 1S subunit) and STAC3 (SH3 and cysteine rich domain 3) are at risk of developing a life-threatening malignant hyperthermia reaction.

MAINTENANCE ELECTROCONVULSIVE THERAPY IN AFFECTIVE DISORDERS

1994 ◽  
Author(s):  
G. N. PAPADIMITRIOU ◽  
Y. G. PAPAKOSTAS ◽  
I. M. ZERVAS ◽  
C. N. STEFANIS
Keyword(s):  
Electroconvulsive Therapy ◽  
Affective Disorders

Systemic Lupus Erythematosus

2017 ◽  
Author(s):  
Richard B. Rosenbaum
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Myasthenia Gravis ◽  
Lupus Erythematosus ◽  
Affective Disorders ◽  
Demyelinating Disease ◽  
Neurological Manifestations ◽  
Systemic Lupus ◽  
Mononeuritis Multiplex ◽  
Cranial Neuropathies ◽  
Confusional States

The neurological manifestations of systemic lupus erythematosus are protean: headache, affective disorders, cognitive dysfunction, seizures, strokes, psychosis, acute confusional states, myelopathies, chorea, mimics of demyelinating disease, meningitis, polyneuropathy, mononeuropathy or mononeuritis multiplex, cranial neuropathies, autonomic dysfunction, Guillain-Barre syndrome, or myasthenia gravis make an incomplete list. Each neurological manifestation needs to be analyzed separately to understand pathogenesis, possible relation to primary lupus-related inflammation and vasculopathy, and optimal treatment.

scholarly journals Treatment Capacity and Clinical Outcomes for Patients With Schizophrenia Who Were Treated With Electroconvulsive Therapy: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Joanne E Plahouras ◽  
Gerasimos Konstantinou ◽  
Tyler S Kaster ◽  
Daniel Z Buchman ◽  
George Foussias ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Treatment Response ◽  
Clinical Outcomes ◽  
Electroconvulsive Therapy ◽  
Psychiatric Treatment ◽  
Long Term Outcomes ◽  
Readmission Rates ◽  
Consent To Treatment ◽  
Maintenance Ect

Abstract Background Patients with schizophrenia are often found incapable to consent to psychiatric treatment. We evaluated clinical outcomes for incapable and capable patients with schizophrenia treated with electroconvulsive therapy (ECT). Methods We conducted a chart review of all inpatients treated with an acute course of ECT between 2010 and 2018 at the Centre for Addiction and Mental Health, Toronto, Canada. Short-term outcomes included treatment response and cognitive impairment. We assessed whether incapable patients regained the capacity to consent to treatment. Long-term outcomes included readmissions and subsequent courses of acute or maintenance ECT. Results A total of 159 (67%) incapable and 79 (33%) capable patients were included. Patients experienced treatment response (incapable, n = 108, 67.9%; capable, n = 52, 65.8%; P = .771) and few experienced cognitive impairment (incapable, n = 21, 13.2%; capable, n = 19, 24.1%; P = .043). A minority of patients were treated with a subsequent course of acute ECT (incapable, n = 46, 28.9%; capable, n = 16, 20.3%; P = .162). Incapable patients were more likely to be treated with maintenance ECT for at least 6 months (incapable, n = 46, 28.9%; capable, n = 13, 16.5%; P = .039). Both groups had similar readmission rates (incapable, n = 70, 44.0%; capable, n = 35, 44.3%; P = 1.000). Eight (5.0%) incapable patients regained capacity and 7 consented to further treatment. Conclusions Irrespective of treatment capacity, the majority of patients demonstrated clinical improvement. Incapable patients experienced less cognitive side effects when compared with capable patients, though they had fewer treatments overall. This study informs clinicians, patients, and substitute decision-makers about the outcomes and challenges of ECT in patients with schizophrenia.

scholarly journals Maintenance Electroconvulsive Therapy and hospital re-admission days among patients with mental illness in Malaysia

2020 ◽  
Author(s):  
Benedict Francis ◽  
Yit Han Ng ◽  
Julian Joon Ip Wong ◽  
Shiau Thin Ling ◽  
Jesjeet Singh Gill ◽  
...  
Keyword(s):  
Mental Illness ◽  
Electroconvulsive Therapy ◽  
Treatment Modality ◽  
Affective Disorders ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
National Data ◽  
Schizophrenia Spectrum ◽  
Maintenance Ect ◽  
Review Study

Abstract Background : Relapse prevention strategies are important as part of optimal patient care. As such, maintenance electroconvulsive therapy (mECT) is an important treatment modality to keep patients in remission longer. Aims : Our study aimed to explore the characteristics of patients receiving maintenance ECT (mECT) and further investigate whether this treatment modality reduces re-admission days in patients with severe mental illness. Methods : A retrospective chart review study design was employed. The medical records of 22 patients followed up at University Malaya Medical centre, were analysed with regards to the outcome measures, which was days of re-admission post mECT, Potential confounders were controlled for via stratification analysis. Results : There was a significant reduction in re-admission days post mECT (p<0.001, r:0.85 ) across all the variables analysed. The variable with the biggest effect size were patients younger than 60 years old (p:0.01, r:0.70), followed by medication with polypharmacy (p:0.002, r: 0.65). The magnitude of reduction in re-admissions was greater in the schizophrenia spectrum group compared to the affective disorders group (r: 0.64 vs. 0.57). Conclusion : Our study provides national data regarding the efficacy of mECT in significantly reducing days of re-admission in patients with treatment resistant schizophrenia spectrum illness and affective disorders. As widespread usage of mECT is still lacking in Asia, our results is encouraging for more practitioners to prescribe mECT for their patients.

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