scholarly journals Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

2021 ◽  
Vol 14 (6) ◽  
pp. 582
Author(s):  
Monika Dominiak ◽  
Anna Z. Antosik-Wójcińska ◽  
Marcin Wojnar ◽  
Paweł Mierzejewski
Keyword(s):  
Major Depression ◽  
Autobiographical Memory ◽  
Electroconvulsive Therapy ◽  
Cognitive Functions ◽  
Rating Scale ◽  
Short Form ◽  
Serious Adverse Events ◽  
Before And After ◽  
Trail Making ◽  
Resistant Depression

Electroconvulsive therapy (ECT) remains the most effective therapy in treatment-resistant depression. However, the safety of ECT has been consistently questioned, particularly among elderly patients. We assessed the efficacy and safety of ECT in patients before and after 65 years old. The study was conducted between 2015 and 2018 and included 91 patients (61 under and 29 over 65 years old) with major depression undergoing ECT. The Hamilton Depression Rating Scale was used to evaluate efficacy. Cognitive functions were assessed using: MMSE, RAVLT, Trail Making Test, Stroop Test and Autobiographical Memory Interview-Short Form. ECT was more effective in older patients as compared to younger (p < 0.001). No serious adverse events were observed in either group. Increased blood pressure and arrhythmias were more common in the older compared to the younger group (p = 0.044 and p = 0.047, respectively), while disturbances of consciousness did not differ between groups (p = 0.820). Most of the cognitive functions remained unchanged compared to baseline, whereas the outcomes of MMSE, RAVLT and Stroop tests showed greater improvements in the older compared to the younger group (all p < 0.05). The decline in the retrieval consistency of autobiographical memory was more pronounced in the younger group (p = 0.024). ECT is a highly effective, safe and well-tolerated method of treating depression regardless of age.

Cognitive Function Before and After Electroconvulsive Therapy in Patients with Major Depression

2017 ◽  
Vol 41 (S1) ◽  
pp. s241-s242
Author(s):  
A. Tmava ◽  
I. Eicher ◽  
D.E. Seitz ◽  
S. Mörkl ◽  
C. Blesl ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Verbal Learning ◽  
Stroop Test ◽  
Trail Making Test ◽  
Before And After ◽  
Trail Making ◽  
Competing Interest ◽  
A Prospective Study

BackgroundDespite its high effectiveness, electroconvulsive therapy (ECT) is not a widely used method to treat depression. One of the reasons for this could be the fear of cognitive side effects. The aim of this study was to investigate effects of ECT on cognitive function.MethodsWe conducted a prospective study with a sample size of 23 patients (10 male), who met the criteria of treatment-resistant depression according to ICD–10 and gave their informed consent for ECT treatment. Before and after ECT, the following investigations have been performed: Beck depression inventory (BDI), Montgomery-Asberg depression rating scale (MADRS), Mehrfachwahl-Wortschatz-Intelligenztest (MWT-B), trail making test (TMT) A and B, stroop-test, mini mental state examination (MMSE) and the German version of the California verbal learning test (MGT).ResultsAfter ECT treatment, we found highly significant changes of depression-scales BDI (P = 0.028) and MADR-Scale (P = 0.001). IQ as measured by the MWT-B (P = 0.851), executive functions as measured by trail making test A (P = 0.568) and B (P = 0.372) and stroop-test, memory functions as measured by the MGT (P = 0.565) (Figure 1) and MMSE (P = 0.678) did not differ significantly after ECT treatment.ConclusionThere were no significant differences in cognitive function before and after ECT treatment. To confirm these findings, it would be necessary to perform larger studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Diet modification impact on ADHD outcome

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Olweya Mohammed Abd El Baaki ◽  
Enas Raafat Abd El Hamid ◽  
Safaa Taha Zaki ◽  
Amani Salah El Din Alwakkad ◽  
Rania Nabil Sabry ◽  
...  
Keyword(s):  
Protein Intake ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Short Form ◽  
Adhd Symptoms ◽  
Parent Rating ◽  
Dietary Analysis ◽  
Dietary Recall ◽  
Diet Modification ◽  
Before And After

Abstract Background Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, affects 5% of children worldwide and characterized by impaired inattention, hyperactivity and impulsivity. One of the risk factors that precipitate ADHD is food. Food affects behavior of children by different ways such as food allergy, food intolerance and gut–microbiota–brain axis. The study aimed to assess effect of diet modification on ADHD outcome and the role of food as a precipitating factor for ADHD symptomatology. The study included 47 children newly diagnosed with ADHD, not receiving medical or behavioral therapy, their ages ranged from 6 to 9 years and their intelligence quotient not below 70 with no associated comorbidities. All participants were subjected to Full history taking, clinical examination, anthropometric measurements, 24 h dietary recall. Dietary analysis and Conner’s parent rating scale-revised short form (CPR-RS) were done before and after diet modification program for 5 weeks. Results There was improvement in ADHD symptoms as measured by CPR-RS after 5-weeks of diet modification program. Carbohydrate and protein intake decreased significantly after diet modification program. Energy intake did not show statistical difference while fat intake increased significantly after the diet program. Vitamin A, C, riboflavin, thiamin and iron intakes decreased significantly after diet program but were within the recommended dietary allowance. Conclusion Following the Diet modification program, ADHD symptoms were improved as documented by decrease in CPR scores. Diminished carbohydrate and protein intake in diet were positively associated with improvement of ADHD symptoms. Diet modification program succeeded in reducing obesity and then ADHD symptoms.

scholarly journals Methylome-wide change associated with response to electroconvulsive therapy in depressed patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lea Sirignano ◽  
Josef Frank ◽  
Laura Kranaster ◽  
Stephanie H. Witt ◽  
Fabian Streit ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Cpg Sites ◽  
Cpg Site ◽  
Depressed Patients ◽  
Resistant Depression ◽  
Functional Pathway ◽  
Regional Analyses ◽  
The Relationship

AbstractElectroconvulsive therapy (ECT) is a quick-acting and powerful antidepressant treatment considered to be effective in treating severe and pharmacotherapy-resistant forms of depression. Recent studies have suggested that epigenetic mechanisms can mediate treatment response and investigations about the relationship between the effects of ECT and DNA methylation have so far largely taken candidate approaches. In the present study, we examined the effects of ECT on the methylome associated with response in depressed patients (n = 34), testing for differentially methylated CpG sites before the first and after the last ECT treatment. We identified one differentially methylated CpG site associated with the effect of ECT response (defined as >50% decrease in Hamilton Depression Rating Scale score, HDRS), TNKS (q < 0.05; p = 7.15 × 10−8). When defining response continuously (ΔHDRS), the top suggestive differentially methylated CpG site was in FKBP5 (p = 3.94 × 10−7). Regional analyses identified two differentially methylated regions on chromosomes 8 (Šídák’s p = 0.0031) and 20 (Šídák’s p = 4.2 × 10−5) associated with ΔHDRS. Functional pathway analysis did not identify any significant pathways. A confirmatory look at candidates previously proposed to be involved in ECT mechanisms found CpG sites associated with response only at the nominally significant level (p < 0.05). Despite the limited sample size, the present study was able to identify epigenetic change associated with ECT response suggesting that this approach, especially when involving larger samples, has the potential to inform the study of mechanisms involved in ECT and severe and treatment-resistant depression.

Knowledge of Attitude Toward Experience and Satisfaction with Electroconvulsive Therapy in a Sample of Iranian Patients

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Malekian ◽  
Z. Amini ◽  
M. Barekatain ◽  
M.R. Maracy ◽  
G. Ahmadzadeh
Keyword(s):  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
High Rate ◽  
Therapeutic Effects ◽  
Freedom Of Choice ◽  
Major Depressive ◽  
Before And After ◽  
Mini Mental Status Examination ◽  
Knowledge And Attitude ◽  
Iranian Patients

Despite the wide consensus over the safety and efficacy of electroconvulsive therapy (ECT), it still faces unfavorable attitudes of patients and families. Little is known about how the experience with ECT affects the patients’ and their families’ attitude toward it. This study examined a sample of Iranian patients and their families regarding their experience with ECT and compared their knowledge and attitude toward ECT before and after this experience and their satisfaction with it. We surveyed 22 patients with major depressive disorder about to undergo ECT and 1 family member of each patient for their knowledge and attitude toward ECT and then surveyed them again after the trial of ECT to compare those variables while assessing their experience and satisfaction with ECT. Patients were rated using the Hamilton Depression Rating Scale and Mini-Mental Status Examination before and after the treatment. Before ECT, family members had a more favorable attitude toward ECT than patients, but after ECT, the patients’ attitude changed more positively. Both patients and their families had a poor knowledge of ECT before the ECT trial, but their total knowledge increased afterward, although not in the areas of indications and therapeutic effects. The majority of patients and their families found ECT to be beneficial and were satisfied with it. There was a high rate of perceived coercion to consent to ECT. Attention should be paid toward educating patients and their families about the ECT as well as informing them about their freedom of choice and right to refuse.

The Effect of Electroconvulsive Therapy On Cognitive Functions in Treatment-resistant Depression

2015 ◽  
Vol 30 ◽  
pp. 837
Author(s):  
A. Bodnar ◽  
M. Krzywotulski ◽  
A. Lewandowska ◽  
M. Chlopocka-Wozniak ◽  
J.K. Rybakowski
Keyword(s):  
Electroconvulsive Therapy ◽  
Cognitive Functions ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression

Efficacy of combinations of antidepressants in the treatment of resistant depression

2011 ◽  
Vol 26 (S2) ◽  
pp. 2078-2078
Author(s):  
C. Hoschl ◽  
M. Bareš ◽  
T. Novák ◽  
M. Kopeček ◽  
P. Stopková
Keyword(s):  
Clinical Practice ◽  
Rating Scale ◽  
Response Rate ◽  
Short Form ◽  
Combination Group ◽  
Number Needed To Treat ◽  
Treatment Resistant ◽  
Madrs Score ◽  
End Of Treatment ◽  
Resistant Depression

In order to compare efficacy of antidepressant monotherapies and combinations of antidepressants, we reviewed retrospectively chart documents of treatment resistant depressive inpatients treated at least 4 weeks with a new antidepressant. Depressive symptoms were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form and Clinical Global Impression at the baseline, week 2, and at the end of treatment. We identified 78 patients (27 treated with combinations and 51 with monotherapies) that fulfilled the criteria for analyses. In comparison with patients on monotherapy, the combination group achieved higher reduction of MADRS score (14.6 vs 10.2 pts., p = 0.02) and response rate (≥ 50% reduction of MADRS, 67% vs 39%, p=0.03). Number needed to treat for response was 4. Based on these results, we suggest that combination of antidepressants might be more effective than monotherapy in clinical practice.

The choice of anesthetics and the effect on the Hamilton depression rating scale in therapy resistant depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S327-S328
Author(s):  
F. van Mensvoort ◽  
R. Teijeiro Permuy ◽  
C. Rijnders
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
Shock Duration ◽  
Hamilton Depression Rating Scale ◽  
Anesthetic Drugs ◽  
Significant Difference ◽  
Before And After ◽  
Resistant Depression ◽  
Competing Interest ◽  
Therapy Resistant Depression

IntroductionThe Dutch guideline ECT does not favor any anesthetic drug during electroconvulsive therapy. Although there are differences in seizure duration which may influence the effect of ECT, ethomidate, methohexital and propofol are “equal”. The influence of switching anesthetics during ECT is unknown. The reason for switching anesthetics is insufficient improvement in depressive symptomatology which is based on clinical picture. The Hamilton is a multiple item questionnaire which can give an indication of depression and which can evaluate recovery.ObjectivesDoes the choice of anesthetics or switching anesthetics influence the effect of ECT on the Hamilton depression rating scale?AimsTo determine whether the choice of anesthetic drugs in the case of switching influences the effect on the Hamilton depression rating scale.MethodsWe collected data of patients who received ECT for therapy resistant depression over the past five years. Choice of anesthetics, eventually switch and the score on the HDRS before and after ECT were included. The data was statistical analyzed.Results50 patients received ECT during past 5 years. ECT gives an improvement on the HDRS in all cases, whether there was a switch or not. Switching from methohexital to ethomidate when shock duration is less than 21 seconds gives a significant difference in improvement on the HDRS (BI 1.288 to 13.538) compared to patients who did not switch.ConclusionsThere are no significant differences on HDRS effect between the different anesthetics. Switching from methohexital to ethomidate gives a significant improvement on HDRS compared with no switch.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Executive function in treatment-resistant depression before and after electroconvulsive therapy

2016 ◽  
Vol 18 (8) ◽  
pp. 624-632
Author(s):  
Zvezdana Stojanovic ◽  
Sanja Andric ◽  
Ivan Soldatovic ◽  
Mirko Dolic ◽  
Zeljko Spiric ◽  
...  
Keyword(s):  
Executive Function ◽  
Electroconvulsive Therapy ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Before And After ◽  
Resistant Depression

Psychometric Assessment of the Therapeutic Efficiency of Antidepressant Agents

1976 ◽  
Vol 4 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Osamah Elwan ◽  
Mostafa Souief ◽  
Mahassen Aly Hassan ◽  
Mahmoud Allam
Keyword(s):  
Rating Scale ◽  
Psychometric Testing ◽  
Psychomotor Retardation ◽  
Psychometric Assessment ◽  
Depression And Anxiety ◽  
Feeling Scale ◽  
Number Of Patients ◽  
Before And After ◽  
Trail Making ◽  
Hamilton Rating Scale

A clinical trial of four weeks duration was conducted involving a tota of thirty depressed patients, of both sexes, aged between twenty and thirty-four years. The total number of patients was divided into three groups of ten patients each. One group received amitriptyline, the second group was administered noxiptyline and the third group was given dibenzepine. All drugs were administered orally. Patients were submitted to psychometric testing before and after drug administration. The tests used included the ‘Hamilton Rating Scale for Depression', the ‘Hildreth Feeling Scale’ and the ‘D Scale’ and the ‘Trail Making Test’ for the evaluation of psychomotor retardation. It was concluded that the Hamilton Rating Scale was the most relatively sensitive test utilized in assessing the depressive state and its improvement. Amitriptyline was found to be mostly anxiolytic; noxiptyline controlled both depression and anxiety to approximately the same extent; and dibenzepine was found to be a mood-elevating drug with an energizing action.

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