The Clinical Efficacy of Maintenance Electroconvulsive Therapy in a Patient with a Mild Mental Handicap

Puri, Basant K.; Langa, Arturo; Coleman, R.

doi:10.1192/bjp.161.5.707

Cited by 25 publications

(5 citation statements)

References 6 publications

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“…Sixteen cases were identified. Seven of the cases were diagnosed with major depression [82][83][84][85][86][87], 2 had bipolar disorder [88,89] and 7 had psychotic depression [90][91][92][93][94]. Kessler notes that three of the cases [92] were individuals with Down Syndrome referred for suspected dementia and one case [88] described treatment of self-injurious behavior rather than bipolar disorder.…”

Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

Diagnosis and Treatment of Mood Disorders in Adults with Developmental Disabilities

Antonacci

Attiah

2008

Psychiatr Q

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While the idea that individuals with developmental disabilities (DD) can suffer from mental illness has been largely accepted since the late 1980's, this is still an underserved and poorly studied population. In particular, mood disorders have traditionally been misdiagnosed, under-recognized and poorly treated. Through the years, reported rates of mood disorders in adults with DD have varied widely. Recent epidemiological studies have focused on community samples and find rates of mood disorders from 3 to 8.1%. Mood disorders are found to be more prevalent than psychotic disorders or anxiety disorders. The empirical literature on assessment of mood symptoms in adults with DD is limited, particularly in individuals with severe and profound DD. Several tools have been developed to assist in identification and diagnosis. However, the work on their psychometric properties and validity studies is still quite limited. The treatment literature is sparse and focused primarily on pharmacotherapy. This review considers the epidemiology and diagnosis of mood disorders in individuals with DD. Recent developments in assessment are reviewed. The literature regarding pharmacological treatment with antidepressants, mood stabilizers, electroconvulsive therapy and antipsychotics is summarized and the current state of psychological treatments for mood disorders in persons with DD is presented. Implications for clinical care and future research are considered.

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Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

Diagnosis and Treatment of Mood Disorders in Adults with Developmental Disabilities

Antonacci

Attiah

2008

Psychiatr Q

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“…However, the use of psychotherapy has been suggested in the mildly retarded [34], and there is at least one article suggesting that a modification of cognitive therapy was efficacious in two depressed mentally retarded individuals [35]. Regarding biological treatments, Puri et al [36] and Kessler [37] reported on sparse literature suggesting that electroconvulsive therapy (ECT) is efficacious in depressed mentally retarded individuals. Kessler [37] reviewed 12 patients with mental retardation who received ECT, and additionally reported on four of his patients.…”

Section: Treatment Of Depressionmentioning

confidence: 97%

Diagnosis and treatment of depression in patients with mental retardation

Janowsky

Davis²

2005

Curr Psychiatry Rep

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Depression in mentally retarded individuals is not uncommon and usually is treatable. However, studies of the diagnosis and treatment of psychiatric illnesses in general and depression specifically in this population are relatively rare. Although Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria can be applied to mildly and moderately retarded individuals, the diagnosis of depression in those with intelligence quotients below 35 is challenging. However, the diagnosis of depression in the latter group is possible using modified criteria emphasizing observational data. Criteria include symptoms such as sadness, irritability, decreased social interaction, regression of skills, sleep disturbances, diurnal variation, and aggression. Furthermore, there is a growing body of evidence that antidepressant treatments, especially administration of selective serotonin reuptake inhibitors, are effective in treating depression in mentally retarded patients. This article reviews numerous studies elaborating on the diagnosis, phenomenology, and treatment of depression in mentally retarded individuals.

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“…Only a handful of studies measured outcome and effects on cognitive function in an objective, standardised manner, using validated rating scales. 12,15,18,29,39 Most authors used subjective clinical observation and judgement to determine outcome, which makes it difficult to compare cases and interpret the outcomes objectively.…”

Section: Study Limitationsmentioning

confidence: 99%

Use of ECT in patients with an intellectual disability: review

2012

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Aims and methodThe literature on the use of electroconvulsive therapy (ECT) in patients with an intellectual disability is scarce, despite a higher prevalence of psychiatric disorders than in the general adult population. We carried out a review of articles published before March 2010. All age ranges, severity of disability and diagnoses were included.ResultsWe found 72 case reports, a retrospective chart review study and other reviews, but no controlled studies. Most patients (79%) showed a positive outcome following ECT. Complications were seen only in 13% and there were no reports of cognitive decline. Many patients relapsed following ECT (32%) and the majority were maintained with medication at follow-up (71%).Clinical implicationsElectroconvulsive therapy is a valuable treatment for this patient group and should be considered earlier as opposed to as a last resort. Obstacles to its use include diagnostic difficulties, ethical and legal issues, a lack of objective measurements and uncertainty about its safety in this population.

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The Clinical Efficacy of Maintenance Electroconvulsive Therapy in a Patient with a Mild Mental Handicap

Cited by 25 publications

References 6 publications

Diagnosis and Treatment of Mood Disorders in Adults with Developmental Disabilities

Diagnosis and Treatment of Mood Disorders in Adults with Developmental Disabilities

Diagnosis and treatment of depression in patients with mental retardation

Use of ECT in patients with an intellectual disability: review

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