Resource Tag: ELECTROCONVULSIVE THERAPY

This brief article describes a carbon monoxide poisoning that occurred in a vehicle with the engine switched off. The author points out that gas lingering inside a car with the engine switched off can be sufficient for serious toxicity to occur. He also notes that the case illustrates the need to look for multiple agents […]

This chapter discusses when to hospitalize a suicidal client. Patients require hospitalization when they refuse to enter stay-alive contracts & threaten to kill themselves. The authors describe how to tell a client they should be hospitalized, & outline the procedures for both voluntary & involuntary hospitalization. They also detail what to expect from hospitalization, & […]

3 cases are reported describing the use of continuation ECT. Continuation ECT consisted of 6 to 12 treatments for about 3 to 6 months after recovery from the index affective episode. Continuation ECT may be indicated in patients with a severe episode of illness, optimal acute response to ECT, & negative response to continuation drug […]

Reviews the role of drugs in the management of the psychiatric disorders that predispose to suicide among the elderly, touches on indications for ECT, & discusses the place of individual psychotherapeutic approaches as adjuncts to pharmacotherapy. 38 refs.

Discusses various aspects of depression in the elderly including diagnosis, depression vs. dementia, masked depression, suicide, depression & physical illness, depression & personality. Treatment includes psychotherapy, antidepressant drugs, & ECT. 11 refs. (LH)

Studied the records of 5729 psych admissions over a 3 yr period in 1 area where ECT was used heavily. 1236 subjects who received ECT were compared with those who did not. ECT recepients were older, more often female & had a greater no. of prev. admissions. ECT subjects did not differ from other subjects […]

The reviewer notes that this monograph surveys various aspects of the biology of suicide & includes an interesting preface by the editor containing a 17 statement summary of the major research findings. The 11 highly technical & abstract chapters which follow report on such topics as: biological markers for suicide risk, clinical electroencephalography, genetics & […]

Ten potential biological markers of suicide risk are discussed along with 4 additional biological aspects of suicide. All markers constitute areas of continuing research rather than established clinical tools. The need for further biological knowledge about suicidal states is emphasized. 61 Refs.(LH)

A representative sample of hospital records of admissions for depression between 1920 and 1982 was analyzed to assess switch rate to hypomania/mania. Analysis of predisposing factors to a switch shows bipolar patients have a higher switch rate (28.9%) than the unipolars (3.7%). A loglinear analysis together with univariate strategies showed no significant increase in switches […]

The author (writing anonymously) discuses his own affective disorder and subsequent treatment with several courses of electroconvulsive therapy (ECT), without which he believes he would have been another suicide statistic. He speaks highly of ECT but acknowledges its controversial nature. The importance of appropriate candidates is emphasized, since patients with character and/or personality disorders do […]

Presents a detailed discussion of the complexities involved in treating suicidal patients. The therapist must be actively & vitally involved with the patient & should include members of the patient’s ecological group in the treatment process. The importance of the initial interview is emphasized, & the decision to hospitalize is explored. Therapeutic strategies include drug […]

Presents a clear, concise discussion of depression including forms of depressive disorders, suicide, causes of depression, treatment options, depression as it appears in various age groups, how to help the depressed person, & where to receive treatment. (LH)

All patients with suicidal ideas represent urgent therapeutic problems. Patients with suicidal drives represent emergency situations parallelling other types of medical and surgical crises. Any psychiatrist, general physician, psychologist or social worker who fails to follow these basic principles flirts with disaster.

Presents a poignant description of a woman’s 40-year struggle with manic-depressive illness. (LH)

Provides discussion of essential points outlining the appropriate use of electroconvulsive therapy if it is to remain available in clinical practice on equal footing with other treatments and without judicial interference. Recommends that further investigation be directed toward finding drugs that can compete with electroconvulsive therapy.

The primary indication for ECT is severe depression, which accounts for 77% of cases treated by this method in the U.S. The author states that 75-85% of depressed patients will respond to this treatment, with acute endogenous depressions showing the largest effects. Several comparison studies involving antidepressant therapy, ECT & placebo indicate that ECT is […]

Discussed are the use of unilateral ECT & questions of how the clinician is to balance the sharply reduced cognitive side effects of unilateral ECT with a therapeutic advantage for bilateral ECT in selecting treatment for a depressed patient. It is suggested that treatment should be initiated with nondominant unilateral ECT except for patients who […]

The mean suicidal ideation scores of 37 patients receiving ECT improved significantly earlier than energy items. However, caution is recommended in prematurely dismissing clinical wisdom regarding suicidal risk during treatment for depression. 6 REFS. (NBB)

The author outlines care principles for those treating depressed & suicidal individuals on an outpatient basis. The use of antidepressant drugs, ECT, psychotherapy, the involvement of a patient’s family &/or friends in treatment, & the use of non-suicide contracts are discussed. Of primary importance is the action of the caregiver: “You have to be willing […]

Dr. Fink examined the clinical records of patients who committed suicide in Bavarian mental institutions to determine whether the increase in suicide rate & attempts from 1950-1959 to 1967-1976 could be related to a change in ECT usage. This data did suggest that decreased use of ECT increased rates; however, the author feels further research […]

Patients with primary affective disorder who had either psychomotor agitation alone or psychomotor retardation alone were studied. Compared to psychomotor retardation, psychomotor agitation appears to be seen more frequently in women, older patients, and individuals who have a late onset to their illness. In addition, those with agitation alone appeared to have a better and […]

In the 30s, the treatment of involutional melancholia left a great deal to be desired. Drugs, mainly barbiturates, were employed. Other forms of treatment were continuous tubs, rehabilitation through ‘moral treatment’, and narcosis therapy. These patients had a 50% chance of getting well and a 25% chance of destroying themselves. With the advent of ECT […]

Also reprinted as “The use of Electroconvulsive Therapy,” in What We Know About Suicidal Behavior and How to Treat It, ed. by S Lesse (Northvale, NJ: Jason Aronson Inc., 1988) p.219-228