The Hospital Treatment of Dementia Præcox

Hamilton, Donald M.; Wall, James H.

doi:10.1176/ajp.105.5.346

Cited by 25 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with acute onset of symptoms and shorter episode duration are more likely to benefit from ECT than are patients with persistent, unremitting symptoms. [34][35][36] Other clinical features, including preoccupation with delusions and hallucinations, fewer schizoid and paranoid premorbid personality traits 34,37 and the presence of catatonic symptoms [38][39][40] have been linked to positive therapeutic effects, but these findings are less consistent across studies. The presence of affective symptoms in schizophrenia is often thought to be predictive of clinical response; however evidence supporting this view is inconsistent.…”

Section: Prediction Of Response To Ectmentioning

confidence: 99%

The Role of ECT in Schizophrenia

Keuneman

Weerasundera

Castle

2002

Australas Psychiatry

View full text Add to dashboard Cite

Objective:To review the place of electroconvulsive therapy (ECT) in the treatment of schizophrenia. Conclusions:ECT is as effective, if not more so, than the antipsychotic drugs in certain clinical settings. It can be rapidly effective in acute episodes. When used alone, antipsychotics have comparable or superior efficacy to ECT alone in the short term. However, ECT possibly confers better long-term outcome. Combination treatment with antipsychotic medications and ECT is superior to either treatment alone, and is safe and effective, notably in medication resistant schizophrenia. Benefits of acute courses of ECT may be short-lived unless maintenance ECT is instituted, although there are limited data on the subject. Clinically, patients with acute onset, shorter episodes are more likely to respond to ECT. Catatonia, preoccupation with delusions and hallucinations, and a relative absence of premorbid schizoid and paranoid personality traits, are other clinical factors less strongly predictive of positive response. The presence of affective symptoms is often thought to be predictive of clinical response. However, there is little research evidence for this. While medications remain the mainstay of treatment in schizophrenia, ECT does have a clear and increasingly recognised role which requires further evaluation.

show abstract

Section: Prediction Of Response To Ectmentioning

confidence: 99%

The Role of ECT in Schizophrenia

Keuneman

Weerasundera

Castle

2002

Australas Psychiatry

View full text Add to dashboard Cite

show abstract

“…Retterstol, 1966) psychogenic psychoses (e.g. female or male patients only (Hamilton & Wall, 1948;Johanson, 1958), have been excluded. Langfeldt, 1939) and other subgroups of the overall schizophrenic population, e.g.…”

Section: Previous Follow-up Studies Of Schizophreniamentioning

confidence: 99%

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

Shepherd¹,

Watt²,

Falloon³

et al. 1989

Psychol. Med. Monogr. Suppl.

261

136

View full text Add to dashboard Cite

Longitudinal studies of schizophrenia based on at least 70 subjects and a minimum five-year follow-up period are reviewed in respect of the requirements of adequate method. A cohort of 121, PSE-diagnosed, schizophrenic admissions from a defined population was identified. The sex-distribution of the subjects was almost equal. Forty per cent were first admissions; 65% of the men and 24% women were unmarried; the mean age of onset for men was 28.6 years, for women 33.2 years. Almost half (48%) were continuously employed (including house and child care) for 2 years prior to admissions. First rank symptoms of schizophrenia were present in 79% of the men and 86% of the women. Comprehensive, standardized assessments of clinical state and social function were made on discharge from hospital and at follow-up by home interview of patient and relative(s). Outcome was also assessed by duration and frequency of readmission and by duration of employment. First admissions were analysed separately from the whole cohort. There were 49 first admissions generating an incidence of 7.4 per 100,000 general population per annum. Sixty-nine per cent of men and 13% of women were unmarried. The mean age of admission for men was 30.8 years, women 40.3 years and the mean age of onset 30.7 and 38.6 respectively. After 5 years first rank symptoms were present in 46% of the males and 35% of the females. The proportion showing depressive symptoms fell from 39% at intake to 22% at five years. In terms of a combination of symptoms and readmissions there was a good outcome in 50% of men and 65% of women, a trend comparable to that found in the whole cohort. For the whole cohort a combination of the number of symptoms and admissions disclosed a good outcome for 48%. The mean total duration of readmissions during the five years for men was 76 weeks and for women 27 weeks. Depressive symptoms were present in 38% at intake and 21% after 5 years. An overall rating of social functioning at 5 years showed no more than mild impairment for 47% of men and 74% of women, although individual items were more impaired. However, 38% of the group showed no more than mild impairment in any aspect of social functioning rated. Clinical and social outcome were, in general, closely correlated. The difference in outcome between men and women and the relations between clinical and social outcome are discussed. By means of an application of measures of association between independent and dependent variables to the onset data the clinical and social categories of pathology and impairment at 5 years were forecast.(ABSTRACT TRUNCATED AT 400 WORDS)

show abstract

“…Early studies reported that good outcome associated with being married [48], having at least a skilled or clerical occupation [48], the absence of pre-morbid personality disturbance and poor pre-morbid functioning [84], the presence of catatonic [41,[85][86][87] or affective symptoms [87,88], and having acute onset and short duration of illness [39,40,44,46,48]. In general, the features associated with the clinical outcome of ECT in patients with schizophrenia overlap substantially with the features that predict outcome with pharmacotherapy [89][90][91].…”

Section: What Can Predict Response To Ect?mentioning

confidence: 99%

Electroconvulsive Therapy for Schizophrenia

Chanpattana¹

2007

CPSR

View full text Add to dashboard Cite

The role of electroconvulsive therapy (ECT) in treating patients with schizophrenia remains unclear. This paper aims to determine whether ECT results in clinically meaningful benefit with regard to psychopathology, behavior and functioning for patients with schizophrenia, and whether variations in the practical administration of ECT influences outcome. Existing research in the field and the new information of research in patients with treatment-resistant schizophrenia (TRS) from Thailand are summarized. Independent of gender, duration of the current episode and severity of baseline negative symptoms predict outcome. Treatment results in marked improvement in positive symptoms, with an intermediate effect on affective symptoms, and no effect or worsening of negative symptoms. The combination of ECT and conventional antipsychotic drug is associated with better outcome than either ECT alone or antipsychotic drug alone during both acute and maintenance phases of treatment. This improvement is not only in psychopathology but also in quality of life and social functioning. Electrical stimulus doses 2-4 times the seizure threshold are likely to increase the speed of recovery with bilateral ECT. Thrice-weekly ECT elicits response faster than does twice-weekly ECT. Although this preliminary evidence supports the use of ECT in patients with TRS, the research base for its use is still inadequate and deserves better investigation.

show abstract

The Hospital Treatment of Dementia Præcox

Cited by 25 publications

References 0 publications

The Role of ECT in Schizophrenia

The Role of ECT in Schizophrenia

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

Electroconvulsive Therapy for Schizophrenia

Contact Info

Product

Resources

About