scholarly journals Electroconvulsive therapy in mood diorders

2015 ◽  
Vol 4 (4) ◽  
pp. 19-23
Author(s):  
S R Adhikari
Keyword(s):  
Comparative Study ◽  
Social Status ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Therapeutic Efficacy ◽  
Rating Scale ◽  
Psychomotor Retardation ◽  
General Anesthetic ◽  
Young Mania ◽  
Prospective Comparative Study

Electroconvulsive therapy (ECT) is one of the less used somatic treatments in mood disorders, especially depressive phase. ECT use has importance during acute bipolar episode when patient extremely violent, suicidal and extreme psychomotor retardation. The aim of this study was to know about socio-demographic profile and therapeutic efficacy of the use of ECT in mood disorders. Methods: This is a prospective comparative study between patients who received ECT and who did not. Psychopathology was evaluated using Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) between the groups at admission, at discharge, at 1st month, at 6th month and at 12th month. Modified ECT was performed using general anesthetic agent. Results: Twenty five patients received ECT as compared to 32 patients who were non-receivers. There was significant decrease in HDRS in ECT receiver as compared to non-receivers in patients with depression (both unipolar and bipolar) at discharge, 1st month, and 12th month; in YMRS in patient with mania at discharge, 1st month and at 12th month.Discussion: There was significant improvement in overall psychopathology and psycho-social status of patients who received ECT as compared to non-receivers. The improvement was shown by decrement in scores in HDRS and YMRS at the time of discharge, 1st month, 6th month and 1st year which were statistically significant.DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11958

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients

2016 ◽  
Vol 25 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Alexey Sidorov ◽  
Prashanth Mayur
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Global Impression ◽  
Treatment Efficacy ◽  
Rating Scale ◽  
Case Series ◽  
Inadequate Response ◽  
Young Mania ◽  
Dramatic Decrease ◽  
Current Case ◽  
Significant Clinical Improvement

Objective: The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. Methods: A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). Results: All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Conclusions: Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

scholarly journals Relating irritability and suicidal ideation using mood and anxiety

2019 ◽  
Vol 22 (3) ◽  
pp. 95-99 ◽  
Author(s):  
Gin Malhi ◽  
Erica Bell ◽  
Pritha Das ◽  
Tim Outhred
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorders ◽  
Clinical Assessment ◽  
Suicidal Behaviour ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Common Symptom ◽  
Young Mania ◽  
Anxious Depression ◽  
The Relationship

BackgroundSuicide is common in the context of depression and bipolar disorders, but there remains a lack of understanding as to how suicide ideation, a common symptom of mood disorders, progresses to suicidal behaviour. Irritability, a feature of some types of depression, is thought to contribute to the development of suicidal behaviour, but these associations are not well established.ObjectiveTo examine the relationship between irritability and suicide ideation according to the subtype of depression expressed in patients with mood disorder.Methods75 patients with mood disorders seen at the CADE (Clinical Assessment Diagnostic Evaluation) Clinic underwent clinical assessment for suicidal ideation (Paykel Suicide Scale), symptom severity (Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D) (anxious depression), Montgomery-Åsberg Depression Rating Scale (MADRS) (melancholic depression)) and irritability (item 5 of the YMRS).FindingsInterestingly, irritability correlated with mania (r=0.734, p<0.001 (YMRS)) and depressive symptom scores (r=0.369, p<0.001 (MADRS); r=0.477, p<0.001 (HAM-D)), which in turn correlated with suicide ideation scores (r=0.364, p<0.01 (MADRS); r=0.275, p=0.017 (HAM-D)). However, despite this indirect association, there was no direct correlation between irritability and suicide ideation (r=0.050, p>0.05).ConclusionsThe nature of the relationship between irritability and suicidal ideation is determined by the emotional context within which irritability operates.Clinical implicationsFindings suggest that rather than examining irritability alone, consideration of the subtype of depression, especially that of anxious depression, should be paramount in assessing suicide risk.

Melancholic symptoms as assessed by the Hamilton Depression Rating Scale and outcomes with and without electroconvulsive therapy on an in-patient mood disorders unit

2010 ◽  
Vol 22 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Keith G. Rasmussen ◽  
Susanna R. Stevens ◽  
Simon Kung ◽  
Amit Mohan
Keyword(s):  
Treatment Outcome ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Clinical Utility ◽  
Rating Scale ◽  
Special Focus ◽  
Hamilton Depression Rating Scale ◽  
Depressed Patients ◽  
Scale Scores ◽  
Hamilton Rating Scale

Rasmussen KG, Stevens SR, Kung S, Mohan A. Melancholic symptoms as assessed by the Hamilton Depression Rating Scale and outcomes with and without electroconvulsive therapy on an in-patient mood disorders unit.Background:We investigated whether 24-item Hamilton Rating Scale for Depression (HamD24)-based melancholia ratings correlated with treatment outcome, with special focus on whether electroconvulsive therapy (ECT) was used in depressed patients treated on an in-patient mood disorders unit.Methods:We analysed the data on ECT- versus non-ECT-treated patients' outcomes relative to melancholia subscale scores. Two HamD24-based melancholia rating scale scores were computed for 201 depressed in-patients at admission and discharge. Baseline melancholia ratings were analysed to see if they correlated with improvement in total HamD24 scores. We also tested to see if the melancholia subscales followed unimodal or bimodal distributions.Results:Melancholic symptoms as assessed by one of the HamD24-based subscales directly correlated with overall improvement. Although ECT treatment was associated with greater improvement than was noted in non-ECT-treated patients, severity of melancholia ratings did not affect this relationship. Finally, both melancholia subscale scores followed approximately unimodal distributions.Conclusions:HamD24-based methods to assess severity of melancholic symptoms have limited clinical utility on an in-patient mood disorders unit in general, and for predicting ECT response in particular. Furthermore, these methods do not seem to identify bimodal populations of depressed patients (i.e. melancholic vs. non-melancholic).

scholarly journals Pulsed Compared to Thermal Radiofrequency to the Medial Calcaneal Nerve for Management of Chronic Refractory Plantar Fasciitis: A Prospective Comparative Study

2016 ◽  
Vol 8;19 (8;11) ◽  
pp. E1181-E1187
Author(s):  
Dina H. el-Hammady
Keyword(s):  
Comparative Study ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Invasive Procedure ◽  
Pain Scale ◽  
University Hospital ◽  
Pulsed Radiofrequency ◽  
Prospective Comparative Study ◽  
Waking Up ◽  
Effective Analgesia

Background: Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations. Objectives: To evaluate the effect of applying PRF for 6 minutes vs. thermal radiofrequency (TRF) for 90 seconds to the medial calcaneal nerve for treatment of chronic refractory plantar fasciitis pain. Study Design: Prospective comparative study. Setting: Pain, Orthopedic, and Rheumatology and Rehabilitation Clinics of Assiut University Hospital. Methods: Twenty patients with refractory chronic bilateral plantar fasciitis received PRF to the medial calcaneal nerve for 6 minutes for one heel and TRF to the same nerve on the other heel (as their own control) for 90 seconds. Numerical verbal rating scale (NVRS) at waking up from bed and after prolonged walking, and satisfaction score were used for assessment of studied patients at one, 3, 6, 12, and 24 weeks from the intervention. Results: All studied patients showed significant improvement in their pain scale after the intervention that lasted for 24 weeks; however, the PRF heels had significantly better pain scale and satisfaction scores at the first and third weeks assessments when compared to the TRF heels. Effective analgesia was achieved after one week or less after PRF compared to 3 weeks for the TRF (P < 0.001). Limitations: No randomization. Conclusions: PRF to the medial calcaneal nerve is a safe and effective method for treatment of chronic plantar fasciitis pain. The onset of effective analgesia can be achieved more rapidly with PRF compared to TRF on the same nerve. Further randomized trials are needed to confirm the therapeutic effect and optimizing the dose of RF needed. Key words: Pulsed radiofrequency, thermal radiofrequency, medial calcaneal nerve, plantar fasciitis, plantar aponeurosis, visual analogue scale

scholarly journals Disturbance of Oxidative Stress Parameters in Treatment-Resistant Bipolar Disorder and Their Association With Electroconvulsive Therapy Response

2020 ◽  
Vol 23 (4) ◽  
pp. 207-216 ◽  
Author(s):  
Qinyu Lv ◽  
Qiongyue Hu ◽  
Wenzhong Zhang ◽  
Xinxin Huang ◽  
Minghuan Zhu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Bipolar Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Enzyme Linked Immunosorbent Assay ◽  
Treatment Resistant ◽  
Young Mania ◽  
Hamilton Depression Rating Scale ◽  
Oxidative Stress Parameters ◽  
Stress Parameters

Abstract Objective Electroconvulsive therapy (ECT) is an effective option for treatment-resistant bipolar disorder (trBD). However, the mechanisms of its effect are unknown. Oxidative stress is thought to be involved in the underpinnings of BD. Our study is the first, to our knowledge, to report the association between notable oxidative stress parameters (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], catalase [CAT], and malondialdehyde [MDA]) levels and ECT response in trBD patients. Methods A total 28 trBD patients and 49 controls were recruited. Six-week ECT and naturalistic follow-up were conducted. SOD, GSH-Px, CAT, and MDA levels were measured by enzyme-linked immunosorbent assay, and the 17-item Hamilton Depression Rating Scale and Young Mania Rating Scale were administered at baseline and the end of the 6th week. MANCOVA, ANCOVA, 2 × 2 ANCOVA, and a multiple regression model were conducted. Results SOD levels were lower in both trBD mania and depression (P = .001; P = .001), while GSH-Px (P = .01; P = .001) and MDA (P = .001; P = .001) were higher in both trBD mania and depression compared with controls. CAT levels were positively associated with 17-item Hamilton Depression Rating Scale scores in trBD depression (radjusted  = 0.83, P = .005). MDA levels in trBD decreased after 6 weeks of ECT (P = .001). Interestingly, MDA levels decreased in responders (P = .001) but not in nonresponders (P &gt; .05). Conclusions Our study indicates that decreased SOD could be a trait rather than a state in trBD. Oxidative stress levels are associated with illness severity and ECT response. This suggests that the mechanism of oxidative stress plays a crucial role in the pathophysiology of trBD.

scholarly journals Electroconvulsive therapy in treatment-resistant mania: case reports

2002 ◽  
Vol 57 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Marcia Britto de Macedo Soares ◽  
Ricardo Alberto Moreno ◽  
Doris Hupfeld Moreno
Keyword(s):  
Electroconvulsive Therapy ◽  
Rating Scales ◽  
Rating Scale ◽  
Case Reports ◽  
Large Body ◽  
Treatment Resistant ◽  
Young Mania ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Bipolar Patients

Electroconvulsive therapy is known to be effective in the treatment of mood disorders, more specifically for depression and mania. Although a large body of evidence confirms the efficacy of electroconvulsive therapy in the treatment of mania, few prospective studies have been done to assess its effectiveness in treatment-resistant manic episodes. These case reports describe the initial results of a study that is being conducted to evaluate the efficacy of Electroconvulsive therapy among treatment-resistant bipolar patients. METHODS: Three manic patients (according to DSM-IV criteria) who were considered treatment-resistant underwent a series of 12 bilateral Electroconvulsive therapy sessions. Before the treatment and then weekly, they were evaluated with the following rating scales: Young Mania Rating Scale, Hamilton Rating Scale for Depression, Brief Psychiatric Rating Scale, and Clinical Global Impressions-Bipolar Version. RESULTS: The 3 patients showed a satisfactory response to Electroconvulsive therapy, although some differences in the course of response were observed. CONCLUSION: These case reports suggest that Electroconvulsive therapy needs further evaluation for the treatment of resistant bipolar patients.

A Case of Catatonia in a 14-Year-Old Girl with Schizophrenia Treated with Electroconvulsive Therapy

2013 ◽  
Vol 41 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Frank Häßler ◽  
Olaf Reis ◽  
Steffen Weirich ◽  
Jacqueline Höppner ◽  
Birgit Pohl ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Response ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Combined Treatment ◽  
Adolescent Patient

This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

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