摘要:

The authors completed a retrospective chart review of the records of all patients identified with diagnoses of mania and schizoaffective disorder, manic type, who underwent electroconvulsive therapy between the years 1973 and 1986 at McLean Hospital. Ten of 18 manic patients (56%) and 3 of 9 schizoaffective patients (33%) experienced meaningful clinical benefit. The authors report the correlation of treatment and patient factors with outcome and review the literature on the convulsive therapy of mania.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A total of 93 bipolar patients admitted in the 1940s were divided into those who received convulsive therapy and those who did not. Clinically, the two groups were similar. Those who received convulsive therapy were discharged back home more frequently, indicating the efficacy of the treatment. Those who received convulsive therapy showed more episodes, both manias and depressions, in the course of their illnesses. The reason for this difference in course of illness is not known, but deserves further exploration. The explanation may involve either biological factors or social circumstances related to a successful treatment outcome.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Electroconvulsive therapy (ECT) effects on monoamine transmitter metabolites in the cerebrospinal fluid (CSF) were evaluated in three patients after completion of a course of bilateral or unilateral ECT. Each patient had earlier undergone an unsuccessful trial with an antidepressant drug. Despite the disparate nature of the basic pharmacology of the antidepressant drugs used, common chronic effects were observed in the CSF, with reductions in 3-methoxy-4-hydroxyphenylglycol (MHPG) and 5-hydroxyindoleacetic acid (5-HIAA) concentrations in all patients despite lack of therapeutic response. Homovanillic acid (HVA) changes were inconsistent. After ECT, however, no CSF changes were observed in the one nonresponder to that treatment. The two ECT responders showed marked increases in CSF 5-HIAA and HVA over their respective baselines, with an elevation in MHPG in one patient only. Further study of the mechanisms of action of ECT should focus on the serotonin and dopamine systems and on the differences between responders and nonresponders.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Baseline and post-electroconvulsive shock (ECS) prolactin levels were determined in serum samples from 13 rabbits, with and without pretreat-ment with the serotonin-2 (5-HT2) receptor blocker ketanserin. Without ketanserin, ECS did not raise serum prolactin levels over baseline. After ketanserin, baseline serum prolactin levels were 50% lower and post-ECS prolactin levels were twice this new baseline level and close to post-ECS prolactin levels without ketanserin. These observations suggest that serotonergic neurotransmission potentiates stress-induced prolactin secretion, but contributes little to ECS-induced prolactin release.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Patients' attitudes towards electroconvulsive therapy (ECT) on their completion of a course of treatment were studied using a semi-structured questionnaire. Twenty-six patients were seen before the junior doctors were trained in ECT administration and 28 patients afterwards. Most patients' attitudes were favourable, although very few fully understood the treatment. Training the junior doctors had no effect on patients' attitudes, but was associated with a shorter mean course length. ECT was acceptable to most patients who received it.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We compared the efficacy of unilateral nondominant (n = 15) and bilateral (n = 31) electroconvulsive therapy (ECT) in melancholia in 46 consecutive, nonrandomly assigned medication-free patients with endogenous depression. Seizure duration was recorded and, if a seizure lasted <25 s, the stimulus was immediately readministered. There were more missed or brief seizures that required restimulation with unilateral ECT than with bilateral ECT. After five treatments, blind assessments on the Hamilton Rating Scale for Depression showed a 57% improvement in the bilateral group as compared with a 19% improvement in the unilateral group. The unilateral group received more total treatments (mean = 9.9) than did the bilateral group (mean = 7.7). At the conclusion of all ECT treatments, 72% of patients receiving bilateral ECT were substantially improved and 14% partially improved, compared with 32% of patients receiving unilateral ECT with substantial improvement and 30% partial improvement. This difference between the two groups, however, had disappeared by the time of discharge. Although unilateral ECT may induce fewer side effects, we find bilateral treatments to be more efficacious, at least on a short-term basis.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This investigation studies number of treatments and seizure duration during a course of unilateral electroconvulsive therapy (ECT) in 82 inpatients with major depressive disorders. Therapy with antidepressants or benzodiazepines preceding ECT was neither related to number of treatments nor to seizure duration. An average dose of methohexital higher than 1.2 mg/kg body weight was associated both with an increased number of treatments and a shorter average seizure duration. Concurrent therapy with neuroleptics was related to a reduced number of treatments. Patients in social class I, more often than others, received fewer treatments.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Endogenous depression is known to be associated with good outcome following electroconvulsive therapy (ECT). In a double-blind, prospective study, we applied three clinical predictive indices and one diagnostic index to a cohort of 29 endogenous depressed patients, to obtain better predictors of outcome following ECT. The Newcastle Prognostic Index identified ECT responders with high specificity but low sensitivity; other indices, such as those described by Hobson (1953) and by Mendels (1967), were neither sensitive nor specific in predictive standards. If ECT-treated depressed patients are preselected for endogenous symptomatology, fresh clinical predictive indices need to be developed.

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0749-8055    

出版商:OVID    

年代:1988

数据来源: OVID