Italian Psychiatry in an International Context: Ugo Cerletti and the Case of Electroshock

Passione, Roberta

doi:10.1177/0957154x04039347

Cited by 44 publications

(31 citation statements)

References 27 publications

(17 reference statements)

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“…Electroconvulsive therapy (ECT) was introduced by Ugo Cerletti in 1938 (Passione 2004). It is an effective treatment for major depressive disorder (MDD) (UK ECT Review Group 2003) and it is used for rapid stabilization of severe MDD patients who are highly suicidal, catatonic, psychotic, or with comorbidities that make pharmacological treatment less tolerable (Lamprecht et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Is Electroconvulsive Therapy Safe for Patient with Very Low BMI? A Case Report

Jl¹,

As²,

Sidi³

et al. 2016

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ABSTRAK Laporan kes ini mengetengahkan kaedah penstablian terapi elektrokonvulsif (ECT) yang cepat bagi pesakit kemurungan major (MDD) yang mempunyai indeks jisim berat badan (BMI ABSTRACTA case of rapid stabilization using electroconvulsive therapy (ECT) for a major depressive disordered (MDD) patient with life-threatening low body mass index (BMI) is reported. This case report focuses on a 55-year-old Malay housewife with underlying hyperthyroidism in a euthyroid state who presented with MDD with mood congruent psychotic features, which were precipitated by the death of her husband. Her BMI was only 11 kg/m 2 due to severe anorexia, and she was highly suicidal. Peripheral total parenteral nutrition was started and ECT was commenced for rapid stabilization on top of tablet escitalopram 15 mg nocte. Full remission was 84 Med & Health 2016;11(1): 83-86 Loo J.L. et al. thinking that her internal organs ceased to function and she no longer existed in this world. To add to it, she had second person auditory hallucination commanding her to kill herself. There were persistent thoughts of ending her life, but she was too weak to attempt suicide. She was admitted for one month and treated with oral fluoxetine, which was optimized until 40 mg daily. In view of poor response to pharmacotherapy and the need of rapid stabilization due to deteriorating physical health, she was transferred to another hospital with psychiatry service and ECT facility. Upon transfer, the patient's depressive symptoms and psychotic symptoms persisted. Examination revealed an alert, dehydrated cachexic Malay lady who appeared older than her age. Her BMI was only 11 (weight 25kg, height 152.5cm) with no hypothermia, hypotension or bradycardia. She was guarded and not fully cooperative. Prominent psychomotor retardation was noticed. Her speech was not spontaneous but relevant and coherent with reduced in tone, volume, rate, and amount. She was depressed and her affect was appropriate, non-reactive and restricted. She had active suicidal idea, nihilistic delusion, and second person auditory hallucination that commanding her to commit suicide. achieved after nine ECTs and steady healthy weight gain was achieved throughout admission. The patient was discharged at BMI of 13 kg/m 2 with good appetite. ECT was safe for very low BMI MDD patient.

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Section: Introductionmentioning

confidence: 99%

Is Electroconvulsive Therapy Safe for Patient with Very Low BMI? A Case Report

Jl¹,

As²,

Sidi³

et al. 2016

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“…A partir da introdução da terapia por febre malárica para o tratamento da neurossífilis, em 1917 1 , nas duas décadas seguintes houve um esforço significativo na busca por terapias psiquiátricas: sonoterapia 2 , choque insulínico 3 , terapia convulsiva (TC) induzida por cânfora e, mais tarde, por cardiazol 4 , lobotomia frontal 5 e uma versão modificada da TC, a eletroconvulsoterapia (ECT) 6 . A TC -cujos primórdios são o foco deste trabalho -é a única intervenção terapêutica remanescente na psiquiatria moderna, embora praticada de uma forma bastante aprimorada, como ECT 7 .…”

Section: Introductionunclassified

O advento do tratamento psiquiátrico moderno: a terapia convulsiva de László Meduna

Baran

Bitter

Ungvári³

et al. 2008

Rev. psiquiatr. clín.

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ResumoA terapia convulsiva (TC) constitui uma das principais contribuições européias ao tratamento psiquiátrico moderno e à psiquiatria biológica. A TC foi introduzida na psiquiatria em 1934 por László Meduna, neuropsiquiatra húngaro. As publicações subseqüentes sobre o primeiro paciente tratado com TC, Zoltán L (ZL), baseiam-se nos artigos e na autobiografia de Meduna. De acordo com essas referências, após quatro anos de estupor catatônico, ZL recebeu TC induzida por cânfora que resultou em plena remissão dos sintomas esquizofrênicos, culminando com alta da instituição. Este artigo reconstrói a história do caso de ZL a partir da recente recuperação de anotações -algumas escritas pelo próprio Meduna -dos Arquivos do Instituto Nacional de Psiquiatria e Neurologia (Hungria). Essas anotações mostram que ZL recebeu repetidas sessões de TC entre 1934 e 1937, primeiramente induzidas por cânfora e depois por cardiazol. A primeira série de TC resultou na suspensão do estupor catatônico e na remissão parcial da psicose. Entretanto, a remissão foi breve e, a despeito de repetidas sessões de TC, ZL nunca esteve inteiramente livre de sintomas, nunca teve alta hospitalar e veio a falecer no Instituto em 1945. Na discussão do caso de ZL, tentamos explicar as possíveis razões das discrepâncias entre o relato de Meduna e as notas originais do prontuário médico. Baran B, et al. / Rev Psiq Clín. 2008;35(4):165-9Palavras-chave: Tratamento convulsivo, cânfora, cardiazol, László Meduna, história da psiquiatria. AbstractConvulsive therapy (COT) is a major European contribution to the psychiatric armamentarium and biological psychiatry. COT was introduced in psychiatry by László Meduna, a Hungarian neuropsychiatrist. All subsequent publications about the first patient treated with COT, Zoltán L (ZL), were based on Meduna's papers and autobiography. After 4 years of catatonic stupor, ZL received camphor-induced COT which resulted in full remission and discharge from the institution. The aim of this paper is to reconstruct ZL's case history from the original case notes-partly written by Meduna himself-which were recovered from the archives of the National Institute of Psychiatry and Neurology. The case notes show that ZL repeatedly received COT between 1934 and 1937, first with camphor and then with cardiazol induction. After the first course of COT the catatonic stupor was resolved and the psychotic symptoms subsided.

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“…infectious disease) and therefore clinical psychiatry and psychiatric research were underfunded with a consequent shortage of beds, an overcrowding of asylums (where living conditions were often abominable), and a cultural stagnation of the discipline 6,7 . The situation was so severe in Italy that in 1942, Cerletti refused to become the president of the Italian Psychiatric Society, in protest against these conditions (despite pressure from politicians) 8 . It should be added that, after 1938, Italian psychiatry and psychoanalysis were also affected by the introduction in of the infamous "racial laws", which caused the expulsion from their institutions of numerous academics and clinicians of Jewish religion or ancestry.…”

Section: Social and Service Background To Ectmentioning

confidence: 99%

“…The genesis of the invention in fact was neither barbaric nor accidental but was the outcome of systematic studies on the effect of seizures on the Central Nervous System begun centuries earlier and built on by Cerletti's team using a technology that was advanced for the time and with a solid scientific basis for the time 8 .…”

Section: The Role Of This Accountmentioning

confidence: 99%

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A translation of "L´Elettroshock" by Cerletti & Bini, with an introduction

Metastasio

Dodwell

2013

Eur. J. Psychiat.

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-The year 2013 marks the 75 th anniversary of the invention of ECT. This paper provides a translation of the 1938 publication by Cerletti and Bini, with an introduction. The authors thought that it would be helpful, in the debate about ECT, to make accessible to people unfamiliar with Italian the first public account of ECT made by Cerletti and Bini in front of the Royal Medical Academy of Rome in May 1938. The introduction and translated paper refer to the methodical approach to the development of ECT, based on the scientific opinions and technological processes of the time, as well as the drive to provide treatment which is both cheaper and more acceptable to patients. The introduction also comments on changing attitudes to what remains an efficacious treatment. ECT has been wrongly represented as an obsolete, unscientific treatment more akin to a torture than to a therapy: some explanations for this are suggested.

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Italian Psychiatry in an International Context: Ugo Cerletti and the Case of Electroshock

Cited by 44 publications

References 27 publications

Is Electroconvulsive Therapy Safe for Patient with Very Low BMI? A Case Report

Is Electroconvulsive Therapy Safe for Patient with Very Low BMI? A Case Report

O advento do tratamento psiquiátrico moderno: a terapia convulsiva de László Meduna

A translation of "L´Elettroshock" by Cerletti & Bini, with an introduction

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