COVID-19 and ECT – a Victorian perspective

Jagadheesan, Karuppiah; Walker, Frances; Danivas, Vijay; Itrat, Quratulain; Lakra, Vinay

doi:10.1177/10398562211014224

Cited by 4 publications

(8 citation statements)

References 7 publications

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“…10 Another single-site study from Australia reported that an ECT team that usually included multiple psychiatrists was reduced to just the ECT director at the beginning of the pandemic. 25 Our study identified that staff safety, in relation to their infection risk, was the primary reason for intentional reductions in ECT staff numbers.…”

Section: Discussionmentioning

confidence: 89%

“…The literature suggests that anxiety among ECT staff in relation to COVID-19 infection is common. 11,25 Effective communication between service leaders and staff may alleviate anxiety. 25 However, the nature of this communication and the extent of its impacts remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…11,25 Effective communication between service leaders and staff may alleviate anxiety. 25 However, the nature of this communication and the extent of its impacts remain unclear.…”

Section: Discussionmentioning

confidence: 99%

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Impact on Electroconvulsive Therapy Services, Including Patient Relapse and Death, During the COVID-19 Pandemic

Sarma¹,

Branjerdporn

McCosker³

et al. 2023

J ECT

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Objectives: Electroconvulsive therapy (ECT) is important in the management of major, life-threatening, and treatment-resistant psychiatric illness. The COVID-19 pandemic has significantly disrupted ECT services. The need for new infection control measures, staff redeployment and shortages, and the perception that ECT is as an "elective" procedure have caused changes to, and reductions in, ECT delivery. The aim of this study was to explore the impact of COVID-19 on ECT services, staff, and patients globally.Methods: Data were collected using an electronic, mixed-methods, cross-sectional survey. The survey was open from March to November 2021. Clinical directors in ECT services, their delegates, and anesthetists were asked to participate. Quantitative findings are reported.Results: One hundred and twelve participants worldwide completed the survey. The study identified significant impacts on services, staff, and patients. Importantly, most participants (57.8%; n = 63) reported their services made at least 1 change to ECT delivery. More than three-quarters (81.0%; n = 73) reported that their service had identified at least 1 patient who could not access ECT. More than two-thirds (71.4%; n = 67) reported that their service identified patients who experienced a relapse in their psychiatric illness due to lack of ECT access. Six participants (7.6%) reported that their service had identified at least 1 patient who died, by suicide or other means, due to lack of ECT access.Conclusions: All ECT practices surveyed were impacted by COVID-19 with decreases in capacity, staffing, changes in workflow, and personal protective equipment requirements with relatively little change to ECT technique. Lack of access to ECT resulted in significant morbidity and mortality, including suicide, internationally. This is the first multisite, international survey to explore the impacts of COVID-19 on ECT services, staff, and patients.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Impact on Electroconvulsive Therapy Services, Including Patient Relapse and Death, During the COVID-19 Pandemic

Sarma¹,

Branjerdporn

McCosker³

et al. 2023

J ECT

View full text Add to dashboard Cite

show abstract

“…Bag-mask ventilation during ECT produces aerosolization of respiratory secretions that pose a high risk of disease transmission during the outbreak of a contagious, airborne virus ( 4 ). Clinicians have attempted to overcome these issues in a number of ways; using adjusted PPE protocols, or delaying and reducing ECT treatments ( 5 , 6 ). Patients may also be considered medically unfit to receive ECT, and alternative treatments for catatonia must be delivered.…”

Section: Introductionmentioning

confidence: 99%

Ketamine as an alternative to ECT in catatonia in elderly women with bipolar disorder: A case report

et al. 2023

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The following paper described two cases of patients with catatonic depression in bipolar disorder (BD) referred to our electroconvulsive therapy (ECT) service. Both were deemed not medically fit for ECT, and were, instead, treated with intravenous (IV) ketamine. Both responded with a resolution of symptoms, returning to baseline level of functioning. During the COVID-19 pandemic, given the risks associated with providing ECT (an aerosol generating procedure) and, in the context of limited resources, ketamine therapy for catatonia is a potentially beneficial alternative or supportive treatment to ECT that merits additional research.

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“…ECT treatment rooms required extra ventilation and cleaning between patients (5). ECT anesthesia aerosol-generating procedure (9), and this limited where ECT could be performed and necessitated changes in anesthetic technique (10,11). In many services, time-intensive pre-treatment COVID-19 screening was introduced (11).…”

Section: Introductionmentioning

confidence: 99%

“ECT should never stop”: Exploring the experiences and recommendations of ECT clinical directors and anesthetists about ECT during the COVID-19 pandemic

et al. 2022

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Electroconvulsive therapy (ECT) is an effective treatment option for severe, treatment-resistant, and life-threating psychiatric illness. The COVID-19 pandemic has significantly disrupted ECT services. Services across North America, Europe, and Australia have reported decreased ECT delivery, and changes in the ways ECT is delivered. This study aimed to identify the impacts of COVID-19 on ECT services globally by exploring clinicians' experiences about ECT during the pandemic, and their recommendations for reducing the negative impacts of the pandemic. Data were collected using an electronic, cross-sectional survey, which included elicitation of free-text responses. The survey was open from March to November 2021. Clinical directors in ECT services, their delegates, and anesthetists were invited to participate. This paper reports the qualitative analysis of responses provided. Fifty-two participants provided qualitative response/s; 74.5% were clinical directors or their delegates, and 25.5% were anesthetists. Greater than one-third of participants were from Australia/New Zealand, and there was also representation from North America, Europe, and the UK. Participants' responses were detailed, averaging 43 words. Three themes were identified: (1) Service provision, about the importance of ECT services continuing during the pandemic, (2) Preparedness, through guidelines and environmental design, and (3) Personal protection, about strategies to increase staff safety. This is the first multi-site, international study to document the experiences and recommendations of ECT clinical directors and anesthetists about the effect of COVID-19 on ECT practice. The findings inform evidence-based practice, and ensure people with major psychiatric illnesses continue to receive ECT during the pandemic.

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COVID-19 and ECT – a Victorian perspective

Cited by 4 publications

References 7 publications

Impact on Electroconvulsive Therapy Services, Including Patient Relapse and Death, During the COVID-19 Pandemic

Impact on Electroconvulsive Therapy Services, Including Patient Relapse and Death, During the COVID-19 Pandemic

Ketamine as an alternative to ECT in catatonia in elderly women with bipolar disorder: A case report

“ECT should never stop”: Exploring the experiences and recommendations of ECT clinical directors and anesthetists about ECT during the COVID-19 pandemic

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