Electric Convulsive Treatment Research Articles

Effects of the modified electric convulsive treatment (MECT) on cell factors of schizophrenia.

The expression of cell factors of schizophrenia and the effect of the modified electric convulsive treatment (MECT) were studied. In total, 156 patients with schizophrenia were selected, and divided into the drug group (70 cases) and the drug combined with MECT group (combined group) (86 cases) according to the treatment methods. In addition, 70 cases of healthy volunteers (control group) were selected according to the closest matching method based on 1:1 of age and gender. The drug treatment, consisted of anti-psychotic drugs, such as risperidone 2–8, quetiapine 300–750, ziprasidone 80–160 or aripiprazole 10–30 mg/day, and for the control group, we used the electric spasm therapeutic instrument, Thymatron®IV Systems up to 6 times, 3 times a week. The levels of interleukin (IL)-10, IL-4, IL-6 and IL-1 were detected before and after treatment by ELISA. The positive and negative symptom scale (PANSS) was used to evaluate the efficiency. Before the treatment, IL-1 and IL-6 levels of drug and combined groups were significantly higher than those of the control group (P<0.05), while IL-4 and IL-10 had no difference with the control group. There was no significant difference of each factor between the drug and combined groups. After treatment, IL-1, IL-6 and IL-10 of the drug group did not change compared to the levels before treatment, but IL-4 increased significantly; IL-1 and IL-10 of the combined group did not change, while IL-4 and IL-6 increased significantly; IL-1, IL-4 and IL-6 of the drug and combined groups were significantly (P<0.05) higher than those in the control group, but not IL-10. IL-1, IL-4 and IL-6 levels of the combined group were significantly higher (P<0.05) than those of the drug group. After treatment, the PANSS scores of the two groups decreased and the combined group decreased more significantly (P<0.05). The reduction rate of the combined group was significantly higher (P<0.05) than that of the drug group. The total efficiency of the combined group was significantly higher than that of the drug group, and after comparing these levels, there was statistical significance (P<0.05). IL-1, IL-4, IL-6 and IL-10 levels of the drug and combined groups before treatment were not associated with PANSS scores and the variation of IL-1, IL-4, IL-6 and IL-10 of the drug and combined groups had no correlation with the reduction rate of the PANSS. The results showed that, cell factors of schizophrenia had an abnormal expression, and medication and MECT can affect the expression level. In addition, MECT can improve the effect in the treatment of schizophrenia, but had no obvious correlation with the change of cell factors.

Effect of remifentanil or esmolol on stress response during electric shock therapy in psychiatric patients

To observe the effects of remifentanil or esmolol on the stress responses during electric shock therapy in psychiatric patients. Upon the approval of institutional Ethics Committee, Eighty psychiatric patients requiring electric shock therapy were randomly divided into 2 groups:esmolol group (Group E) and remifentanil group (Group R) (n = 40 each). The patients in Groups E and R were injected with esmolol 1 mg/kg or remifentanil 2 µg/kg respectively before induction of anesthesia. Electric shock therapy was performed after a disappearance of fasciculation. MAP (mean arterial pressure) and HR (heart rate) were recorded at the following time points:prior to anesthesia (T0), prior to electric shock therapy (T1) and at 1 min (T2), 3 min (T3) & 5 min (T4) after electric shock therapy. Venous blood samples were collected at (T0) and (T4). The plasma levels of cortisol and norepinephrine were determined by enzyme-linked immunosorbent assay. The levels of MAP and HR at T2, T3 were significantly higher than those at T0 in Group E (P < 0.05). And the levels of cortisol and norepinephrine at T4 were significantly higher than those at T0 in 2 groups (P < 0.05). However, their levels were significantly higher in Group E than those in Group R (P > 0.05). In modified electric convulsive treatment, remifentanil is superior to esmolol in maintaining the stabilization of cardiovascular system and effectively inhibiting the stress responses.

Sense of coherence and psychiatric morbidity in terms of anxiety and depression in patients with major depression before and after electric convulsive treatment

The specific aim of this study was to explore if the Sense of Coherence (SOC) Scale reflects and overlaps with standardized psychiatric assessments of depression and anxiety leading to the main hypothesis that the degree of depression decreases while the SOC scores remain stable. Fifteen patients with a diagnosis of major depression according to Axis I in DSM-IV and planned electric convulsive treatment (ECT) participated in the study. The clinician-rated instruments, Montgomery Asberg Depression Rating Scale (MADRS) and Global Assessment of Function (GAF), and the self-assessment instruments such as SOC and the Comprehensive Psychopathological Rating Scale-Self Rating Scale for Affective Syndromes (CPRS-S-A) were used before and after the treatment. The patients showed statistically significant improvements in clinician-rated depression (p < 0.001) and functional status (p < 0.001), and in self-rated anxiety (p = 0.001) and depression (p = 0.003). There was no significant improvement in SOC (p = 0.213). No significant correlations were found between the SOC scores and any of the measures except for GAF after treatment (r = 0.57, p = 0.039); the lower the SOC scores the greater was the functional dysfunction. In conclusion, the SOC Scale seems not to be a measure of psychopathology in terms of depression or anxiety merely.

The analysis on the side effects occurred in the psychotic patients treated with modified electric convulsive treatment (MECT) and the nursing measures for such patients

目的 分析无抽搐电休克(MECT)治疗精神病患者的不良反应并提出护理措施.方法 回顾分析了我院82例精神病患者接受MECT治疗共515次中出现的各类不良反应.结果 82例精神病患者在接受MECT治疗过程中,出现自主呼吸恢复时间超过6 min以上者16例,暂时记忆障碍者5例,颈、胸部大片红疹者9例,呼吸道分泌物过多5例,烦躁不安62例,头痛不适8例.结论 MECT治疗过程中的不良反应有一定的危险性,不容忽视.密切观察病情变化、采取及时有效地加压吸氧、侧卧位、适当的约束保护及良好的心理沟通是保证患者安全的重要措施。

The effects of electroconvulsive shock on dopamine-1 and dopamine-2 receptor ligand binding activity in MPTP-treated mice.

To explore the possible therapeutic use of electric convulsive treatment in Parkinson's disease (PD), the authors examined the biochemical effects of electroconvulsive shock (ECS) on dopaminergic systems in a rodent model of PD, induced with the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). MPTP increased dopamine turnover, as indicated by an increase in the ratio of the dopamine metabolites dihydroxyphenylacetic acid and homovanillic acid to dopamine. [3H]Spiperone binding to the D2 site increased after lesioning of striatal dopamine terminals. With ECS alone, no changes were found in monoamine levels, brain monoamine oxidase activity, or the D2-labeled sites measured 24 hours after the last treatment. [3H]SCH-23390 binding to the D1 site increased after ECS. In MPTP-treated mice, ECS also increased [3H]SCH-23390 binding to the D1 site, whereas [3H]spiperone binding to the D2 site was unchanged compared to control or to only ECS-treated animals, and decreased compared to the MPTP-treated group that did not receive ECS. ECS appears to selectively modify both the D1 and D2 sites when given after MPTP, increasing the binding of a D1 radioligand and decreasing the binding of a D2 radioligand.

Spastic constriction of cerebral vessels after electric convulsive treatment.

The brains of nine cats were subjected to bitemporal electric convulsive treatment. The current (AC, 220 V, 50 Hz, ca. 500 mA, 500 ms) was applied two to five times. Pial vessels were observed through a skull window. Immediately after current application, some pial arteries exhibited segmental spastic constriction which usually did not disappear until the animals were killed. Before sacrificing the animals, 20 min after convulsive treatment they were perfused with a carbon suspension. In some cortical areas blackening was impaired indicating that perfusion was not complete. Electron-microscopic investigation revealed that spasm also occurred in arterioles of the brain parenchyma. Many arterial vessels, some of them possessing only one muscular cell sheat, had collapsed so that the lumen was merely a small cleft. The spasms were irregularly distributed and confined to small segments of the vessel. Small arteriolar vessels were more affected than large pial arteries. Arterial spasms continued for 20 min. In a total of 39 control animals spastic constriction was observed only once; this animal had been subjected to prolonged hypocapnia.

CALCIUM METABOLISM IN STATES OF DEPRESSION.

We have previously demonstrated, in small groups of patients receiving either electric convulsive treatments or imipramine therapy, changes in calcium metabolism associated with recovery from states of depression (5, 7). Other investigators have also reported somewhat unusual changes in calcium physiology among depressed patients or during the administration of antidepressant therapies. These include low cerebrospinal fluid calcium levels (4), changes in blood calcium during electric convulsive treatments (10), and alterations in bound and ionized fractions of blood calcium during imipramine therapy (3). It is the purpose of this report to describe and discuss the changes in urinary calcium excretion in the relatively large series of patients we have now acquired.

The effects of electric convulsive treatments on nitrogen, calcium, and phosphorus metabolism in psychiatric patients.

This investigation was designed to determine whether significant alterations in the metabolism of nitrogen, calcium, and phosphorus occur in psychiatric patients during the therapeutic administration of electric convulsive treatments. Gour and Chaudhry (1) observed transient changes in serum calcium following grand mal convulsions in a series of patients. Jarvie and Mulligan (2), repeating this experiment in patients receiving muscular relaxants during the administration of E.C.T., failed to demonstrate similar calcium changes. More intimate knowledge of electrolyte metabolism can be obtained by means of balance techniques (3), whereby the degree of retention or loss of a particular substance can be ascertained by maintaining each patient on a constant daily intake and regularly determining the urinary and stool excretion of that substance.

Cutis Anserina: Its Significance in the Prognosis of Mental Illness

The autonomic nervous system activity that has been observed to accompany grand mal epilepsy does not occur consistently with the seizures produced by electric convulsive treatment. The dilated pupils, flushing, lacrimation and gooseflesh which appear during the tonic spasm of the electrically induced seizure, and which are the outward manifestations of the autonomic storm within, are often not readily observed because of their transience; they begin to fade almost as soon as they appear and may be gone with the onset of the clonic spasm. Different patients exhibit them in different degrees and the same individual may show changes in the amount of autonomic response over a course of treatments.

Changes in catechol amine response to successive electric convulsive treatments.

Changes in sympathetic nervous system responses have been noted to accompany changes in psychological states during psychiatric treatment. Funkenstein, Greenblatt and Solomon, observing the blood pressure response to epinephrine and methacholine, have reported a change in blood pressure patterns on the part of patients who benefited from electric shock treatment (1). Gellhorn has presented evidence that improvement in the psychoses is associated with heightened sympathetic reactivity (2).

Special Unit for Electric Convulsive Treatment

Special Unit for Electric Convulsive Treatment

Case report of grand mal convulsions following more than 150 electric convulsive treatments: a clinical and electro-encephalographic study.

Seizures following electric convulsive treatments are a complication which might be avoided by the judicious teamwork of the electro-encephalogram and the clinician. To avoid this complication, electro-encephalograms before and during convulsive therapy help the clinician decide on the frequency or discontinuation of the treatment.

The effect of xylocain in electric convulsive treatment.

Es hat sich gezeigt, dass Xylocain in kleinen intravenosen Dosen die epileptiformen Nachentladungen bei Elektroschockbehandlung abkurzen kann. Die Untersuchungen werden fortgesetzt, um die Bedeutung der Nachentladungen fur die klinischen Effekte der Elektroschockbehandlung zu beleuchten.

Studies on mescaline. II. Electro-encephalogram in schizophrenics; effects of administration after electric convulsive treatment of schizophrenic patients.

The post-electric-shock electro-encephalograms of eight schizophrenic patients were studied following the intravenous injection of 0.5 grams of mescaline sulfate in each. A symmetrical suppression of high voltage, slow wave activity was noted in tracings taken at the first and fourth hours. At the twenty-fourth hour, the patterns had returned to pre-test levels in six of eight patients. It has been demonstrated that the high voltage bursts and slow wave activity appearing after electric convulsive treatment originated in the diencephalon. Since mescaline suppresses these slow waves, the diencephalon would appear to be one of its areas of action.

Memory Loss Following Electric Convulsive Treatments

Memory Loss Following Electric Convulsive Treatments

CONDITIONAL RESPONSES IN PATIENTS RECEIVING ELECTRIC SHOCK TREATMENT

Ability to form a conditional response to a slightly painful stimulus was tested in 10 patients before, during, and after electric shock therapy. Fifty-two experiments revealed decline in performance in 6 patients. In one the deficit disappeared within 24 hours, and in another within 2 weeks after the last seizure. Two were not tested beyond 2 weeks after treatment, and in the other 2 the impairment lasted at least 3 and 9 weeks respectively. In one of these the defect persisted through a second course of electric convulsions one month later. A seventh patient with a uniformly poor record showed an organic type deficit more definitely 2 weeks after the last seizure. This failure to adapt defensively to the experimental situation appears to be related to the number of convulsions the patient has undergone. The nature of the impairment is discussed together with some of the pertinent literature. Its essential features appear to be limitation of associative range and inability to analyze and synthetize sequentially related temporal relationships. Together with data from animal experimentation the findings suggest that important adaptive, organically determined deficits may occur more often as a result of electric convulsive treatment than are clinically recognizable.

Observations and opinions concerning complications and contraindications in electric convulsive therapy

An attempt has been made to evaluate the present status of complications and contraindications to electric convulsive treatment, by an analysis of the complications reported in the literature and by observation of the writers' experience for the past two and a half years in about 14,000 treatments at this center. It is concluded that there now appear to be fewer contraindications than was believed in the earlier days of this therapy.

Postconvulsive psychopathologic states in electric convulsive treatment.

Postconvulsive psychopathologic states in electric convulsive treatment.

ELECTROENCEPHALOGRAPHIC STUDY OF ELECTRIC SHOCK THERAPY

IT IS recognized that electric shock therapy produces recovery in a surprising number of mentally sick people, but not a great deal is known about the exact healing mechanisms. In a previous study 1 a broad clinicotheoretic approach was made to this problem, attempting to integrate and correlate various physiologic and psychobiologic factors in the curative process. The present paper is confined primarily to the sequence of neurophysiologic events reflected in the electroencephalographic series. Always keeping in mind that the electroencephalogram registers only the physiologic state of the brain and its disturbances, and chiefly the activity from the convexity of the cerebrum, one can still derive a great deal of information about what occurs when the patient is subjected to a series of electric convulsive treatments. MATERIAL AND METHODS Material. —Our patients comprised a series of 106 psychotic, men—Naval, Marine and Coast Guard personnel—evacuated from the Pacific area. Most of

Shock therapy during pregnancy

1. Three cases of pregnant patients who have been treated with various forms of shock therapy are added to those already reported. 2. One manic-depressive went through pregnancy uneventfully while receiving electric convulsive therapy in the sixth and seventh months of gestation. 3. One paranoid schizophrenic miscarried at about four months while receiving her third course of combined electric convulsive therapy and ambulatory insulin. 4. One paranoid schizophrenic went through pregnancy to normal delivery while receiving 90 days of insulin (including eight genuine coma days) and 20 electric convulsive treatments in the fifth, sixth, and seventh months of gestation. 5. Pregnancy should not necessarily be considered an indication to deprive a psychotic woman of needed shock therapy.