[Electroconvulsive therapy in patients with metallic skull implants]. / Elektroconvulsietherapie bij patiënten met metallische schedelimplantaten.

BACKGROUND: Electroconvulsive therapy is an effective treatment for mood disorders. There is, however, no consensus about the safety of use in patients with metallic skull implants even though these patients are at higher risk of developing mood disorders. AIM: To bundle the existing literature concerning the use of electroconvulsive therapy in patients with metallic skull implants and to examine the evidence concerning safety and efficacy in this group. METHODS: Relevant case reports and literature reviews published since 1950 were located using PubMed. RESULTS: We selected and reviewed 37 case reports. There were no complications related to the interaction between electroconvulsive therapy and the metallic objects. Psychiatric outcomes were positive in 95% of cases. CONCLUSION: There is no evidence that electroconvulsive therapy is unsafe in patients metallic skull implants. With appropriate caution, its use can be considered on a case-by-case basis by psychiatrists.

Real-World Treatment Patterns, Outcomes, Resource Utilization and Costs in Treatment-Resistant Major Depressive Disorder: PATTERN, a Retrospective Cohort Study in Belgium.

OBJECTIVE: Treatment-resistant depression (TRD), a subgroup of major depressive disorder (MDD) that does not adequately respond to treatment, has a substantial impact on the quality of life of patients and is associated with higher medical and mental health care costs. This study aimed to report real-world treatment patterns, outcomes, resource utilization, and costs in the management of TRD by psychiatrists in Belgium. METHODS: We conducted a retrospective, non-interventional cohort study of patients ≥ 18 years, with diagnosed MDD who are treatment-resistant, defined as not responding to two different antidepressant treatments in the current moderate to severe major depressive episode (MDE). Data obtained from medical records of patients included patient health state (MDE, response, remission, and recovery) and resource use (number of consultations and emergency room visits, non-drug and drug interventions, and hospitalizations). RESULTS: One hundred and twenty-five patients were enrolled in nine sites, with an average observation period of 34 months. During the MDE, 89.7% of patients were treated with selective serotonin reuptake inhibitors, 63.2% with serotonin-norepinephrine reuptake inhibitors, and 60.8% with anti-psychotics. Twenty-four percent of patients did not respond to any treatment; 76% responded, of whom 61% experienced a relapse; 28% of patients reached recovery, of whom 31.4% experienced recurrence. The average yearly direct cost of a TRD patient is €9012, mainly driven by hospitalization in the MDE. The observed absenteeism relates to a high indirect cost, representing 70% of the total MDE cost. CONCLUSION: TRD is associated with a high unmet need and economic burden for patients and society, with highest costs in the MDE health state driven by absenteeism.

Patterns of EEG dysfunction in general hospital psychiatry.

Patterns of EEG dysfunction in clinical psychiatry are badly documented. Population variables in patients admitted to the psychiatric ward of a general hospital (n = 1,285) compared to a sample referred for EEG recording (n = 1,200) are reported. Prevalence of EEG dysfunction in referrals is high (42.5%) and the reported selection criteria appear clinically valid. The type of EEG dysfunction largely depends on age and recognizable patterns in general hospital psychiatry include drug effects, epilepsy in mental retardation and organic brain syndromes in the elderly. Similar data in other types of mental institutions are highly mandatory.

Membrane resting potentials in cultured mouse neuroblastoma cells.

Membrane resting potentials (MRP) were measured systematically in cultured mouse N2A neuroblastoma cells: in the logarithmic growth phase; in subconfluent cultures; in confluent cultures; after dBcAMP had induced morphological differentiation. Neurite extension was accompanied by a significant increase in MRP as compared to the appropriate controls. No significant differences in MRP were observed with regard to the different growth phases.