Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

Abstract

Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT) at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP) were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02). Thirtyfour percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5%) reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients. Keywords: Electroconvulsive therapy, treatment outcome, psychiatric somatic therapies, treatment, general hospital psychiatry. ResumoObjetivo: Descrever o perfil sociodemográfico e clínico de pacientes submetidos a eletroconvulsoterapia (ECT) em um hospital geral universitário. Método: Neste estudo retrospectivo, foram revisados os prontuários de todos os pacientes submetidos a ECT entre janeiro de 1988 e janeiro de 2008 na unidade psiquiátrica do hospital geral da Universidade Estadual de Campinas (UNICAMP). Os pacientes/familiares foram contatados por telefone para a coleta de dados de seguimento. Resultados: Um total de 200 prontuários foram revisados. A maioria dos pacientes era do sexo feminino, com uma idade média de 39 anos e história de hospitalização psiquiátrica prévia. As principais indicações para ECT foram depressão e catatonia. Complicações foram observadas em menos de metade dos casos, e a maioria delas teve caráter temporário e não grave. Houve resultado psiquiátrico favorável em 89,7% dos pacientes, especialmente os catatônicos (100%, p = 0,02). Trinta e nove por cento dos casos foram contatados por telefone, a uma média de 8,5 anos decorridos entre o procedimento e o contato. Entre estes, três (1,5%) relataram transtornos amnésticos persistentes e 73% consideraram a ECT um bom tratamento. Conclusão: A ECT foi realizada de acordo com diretrizes internacionais. Na grande maioria dos casos, efeitos indesejáveis foram temporários e não graves. A resposta à ECT foi positiva na maioria dos casos, especialmente em pacientes catatônicos. Descritores: Eletroconvulsoterapia, resultado de tratamento, tratamentos somáticos em psiquiatria, tratamento, unidad...

Understanding the Patient Landscape: A Ten-Year Retrospective Examination of Electroconvulsive Therapy in Romania’s Largest Psychiatric Hospital

“…Furthermore, those who continued with the same dose or received a higher dose of antipsychotics post-ECT had lower rates of readmission. In patients requiring rehospitalization, it was identified that a higher number of ECT sessions were required (7)(8)(9)(10)(11)(12), as opposed to those with depressive disorder, where 4-6 sessions were performed.…”

“…Mortality typically ranges from 2 to 4.5 deaths per 100,000 procedures, which is similar to the anesthetic risk observed in minor surgeries [9]. Significant complications include confusion, delirium, transient headache, muscle soreness, nausea, vomiting, prolonged seizures, dental damage, and circulatory failure [10].…”

Electroconvulsive therapy: historical construction of nursing care (1989-2002)

“…ECT stimulus causes activation of the Parasympathetic System causing bradycardia and lowering of blood pressure and, consequently, activation of the Sympathetic System, causing opposing effects such as: increase in blood pressure, heart rate and an overall increase in cardiac output (2) . These effects may lead to cardiorespiratory arrest and, therefore, the nursing team should closely observe these parameters, since the side effects of ECT are generally transient and benign, however, most cases of death related to ECT are of cardiovascular origin (16) .…”

“…When well evaluated and discussed, ECT is an effective and safe technique, sometimes with minor damage and efficacy that is clearer than psychotropic drugs, and provides a rapid and necessary response in some cases (16) .…”

Eletroconvulsoterapia em perspectiva ou para a crítica do eletro-choque

“…Se tal ciência de classe legitima o status quo, sua tecnologia tem a finalidade de controle e docilização de corpos potencialmente subversivos. Alguns estudos demonstraram o predomínio da técnica no público feminino, psicótico grave e depressivo (Pastore et al, 2008;Santos Jr. et al, 2013). A predominância da técnica no público feminino, malgrado as especificidades regionais que contextualizam tais estudos, pode ter inúmeros significados, incluindo o dado de que é o público mais acometido por transtornos de ansiedade, de humor e somatoformes no Brasil (Ludermir, 2008;Siqueira, 2010).…”