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1.
Int J Neural Syst ; 29(7): 1950005, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31387489

RESUMO

Although electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder (MDD), the mechanism underlying the therapeutic efficacy and side effects of ECT remains poorly understood. Here, we investigated alterations in the cortical morphological measurements including cortical thickness (CT), surface area (SA), and local gyrification index (LGI) in 23 MDD patients before and after ECT. Furthermore, multivariate pattern analysis using linear support vector machine (SVM) was applied to investigate whether the changed morphological measurements can be effective indicators for therapeutic efficacy of ECT. Surface-based morphometry (SBM) analysis found significantly increased vertex-wise and regional cortical thickness (CT) and surface area (SA) in widespread regions, mainly located in the left insula (INS) and left fusiform gyrus, as well as hypergyrification in the left middle temporal gyrus (MTG) in MDD patients after ECT. Partial correlational analyses identified associations between the morphological properties and depressive symptom scores and impaired memory scores. Moreover, SVM result showed that the changed morphological measurements were effective to classify the MDD patients before and after ECT. Our findings suggested that ECT may enhance cortical neuroplasticity to facilitate neurogenesis to remit depressive symptoms and to impair delayed memory. These findings indicated that the cortical morphometry is a good index for therapeutic efficacy of ECT.


Assuntos
Córtex Cerebral/diagnóstico por imagem , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/terapia , Eletroconvulsoterapia/métodos , Máquina de Vetores de Suporte , Adulto , Transtorno Depressivo Maior/psicologia , Eletroconvulsoterapia/tendências , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Máquina de Vetores de Suporte/tendências
2.
Pathologica ; 111(2): 79-85, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31388201

RESUMO

In the conviction that a look at the past can contribute to a better understanding of the present in the field of science too, we discuss here two aspects of the relationship between early 20th century anatomic pathology and psychiatry that have received very little attention, in Italy at least. There was much debate between these two disciplines throughout the 19th century, which began to lose momentum in the early years of the 20th, with the arrival on the scene of schizophrenia (a disease histologically sine materia) in all its epidemiological relevance.The First World War also contributed to the separation between psychiatry and pathology, which unfolded in the fruitless attempts to identify a histopathological justification for the psychological trauma known as shell shock. This condition was defined at the time as a "strange disorder" with very spectacular symptoms (memory loss, trembling, hallucinations, blindness with no apparent organic cause, dysesthesias, myoclonus, bizarre postures, hemiplegia, and more), that may have found neuropathological grounds only some hundred years later.Among the doctors with a passed involvement in the conflict, Ugo Cerletti, the inventor of electroshock treatment, focused on the problem of schizophrenia without abandoning his efforts to identify its organic factors: if inducing a controlled electric shock, just like an experimentally-induced epileptic seizure, seems to allay the psychotic symptoms and heal the patient, then what happens inside the brain? In seeking histological proof of the clinical effects of electroconvulsive therapy ("the destruction of the pathological synapses"), and attempting to isolate molecules (that he called acroagonins) he believed to be synthesized by neurons exposed to strong electric stimulation, Cerletti extended a hand towards anatomic pathology, and took the first steps towards a neurochemical perspective. However his dedication to finding a microscopic explanation for schizophrenia - in the name of a "somatist" approach that, some years earlier, the psychiatrist Enrico Morselli had labelled "histomania" - was unable to prevent psychiatry from moving further and further away from anatomic pathology.


Assuntos
Eletroconvulsoterapia/tendências , Psiquiatria/tendências , Choque Traumático/psicologia , Choque Traumático/terapia , Distúrbios de Guerra/patologia , Distúrbios de Guerra/psicologia , Distúrbios de Guerra/terapia , Eletroconvulsoterapia/métodos , Eletrochoque , Humanos , Itália , Psiquiatria/métodos , Choque Traumático/patologia , I Guerra Mundial
3.
Australas Psychiatry ; 27(5): 477-479, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287328

RESUMO

OBJECTIVE: The purpose of this opinion article is to review the recent evidence base in relation to the role of electroconvulsive therapy (ECT) in the management of patients with schizophrenia. Specifically, we explore the efficacy and safety of ECT. Furthermore, consideration is given to the profile of patients who benefit most from ECT, the role of maintenance ECT and what happens when ECT is not given. CONCLUSION: Our brief review of the evidence suggests that clinical practice in developing countries has not kept up with the growing literature supporting ECT use in schizophrenia. As such, we advocate that ECT should not be a treatment of last resort. Rather, it should be considered more readily as an add-on therapy when there has been a poor response to antipsychotic medications or concerns exist about side effects. Further research is needed into the efficacy of maintenance ECT.


Assuntos
Eletroconvulsoterapia , Esquizofrenia/terapia , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/estatística & dados numéricos , Eletroconvulsoterapia/tendências , Humanos
4.
Psychiatry Res ; 273: 759-766, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31207863

RESUMO

Electroconvulsive therapy (ECT) has been suggested as a treatment for augmenting the response to clozapine in patients that do not respond well to clozapine alone and maintenance ECT (M-ECT) had also been recommended to sustain improvement. This retrospective study of up to 2 years of observation was conducted to explore whether M-ECT is beneficial for long-term maintenance of the symptom remission elicited by acute ECT. Positive and Negative Syndrome Scale (PANSS) were plotted for each patient and compared using a linear mixed-effect model. A total of thirty-eight patients were followed and classified into three groups: (1) clozapine alone (CZP, n = 15), (2) acute ECT only (A-ECT, n = 11), and (3) acute ECT with M-ECT (M-ECT, n = 12). The mean number and interval of ECT sessions during the maintenance period in the M-ECT group were 39.0 ±â€¯26.7 and 15.6 ±â€¯8.4 days, respectively. The slope of the M-ECT group eventually declined, but that of the A-ECT group gradually increased back to the pre-ECT level. No persistent or serious adverse effects were observed. In conclusion, A-ECT augmented the effect of clozapine, but M-ECT was required for sustaining symptom improvement.


Assuntos
Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Eletroconvulsoterapia/psicologia , Eletroconvulsoterapia/tendências , Esquizofrenia/terapia , Adulto , Idoso , Terapia Combinada/métodos , Eletroconvulsoterapia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
6.
Psychiatry Res ; 276: 107-111, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31048180

RESUMO

Electroconvulsive therapy (ECT) as well as the diseases it treats have been associated with stroke and cognitive impairment. We investigate the relationship between ECT and the subsequent development of stroke in patients with different severe mental illnesses. Tapping Taiwan's National Health Insurance Research Database, we identified patients diagnosed with severe mental illnesses who had received ECT between Jan 1, 2002 and Dec 31, 2007. A comparison cohort was constructed of patients who were matched by age, gender, and diagnosis but did not receive ECT. The patients were then followed up for occurrence of subsequent new-onset stroke. We identified 6264 patients had been diagnosed with mental illness and had received ECT. They were matched with 18,664 mentally ill patients who had not. The study cohort had a lower incidence of subsequent stroke than the matched controls, after controlling for age, diabetes, hypertension, coronary heart disease and enrollee sociodemographic category, risk factors for stroke in both study and control cohorts. ECT is associated with reduced risk of subsequent stroke in patients with severe mental illnesses in Taiwan. Therefore, clinicians should not let risk of stroke stop them from suggesting ECT to physically healthy patients who might benefit from this therapy.


Assuntos
Eletroconvulsoterapia/métodos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Vigilância da População , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controle , Adulto , Idoso , Estudos de Coortes , Eletroconvulsoterapia/tendências , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Programas Nacionais de Saúde/tendências , Estudos Retrospectivos , Fatores de Risco , Comportamento de Redução do Risco , Acidente Vascular Cerebral/psicologia , Taiwan/epidemiologia
7.
Brain Stimul ; 12(4): 1041-1050, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31000384

RESUMO

INTRODUCTION: The induction of brain-derived neurotrophic factor (BDNF) release and subsequent restoration of neuroplastic homeostasis may underlie the effects of electroconvulsive therapy (ECT). OBJECTIVES: We aimed to assess serum and plasma BDNF levels during the course of acute ECT, as well as before and after subsequent continuation ECT, in patients with depression. METHODS: We included 24 patients with major depressive disorder (mean age ±â€¯SD: 54.5 ±â€¯13.7; f/m: 17/7; baseline 17-item Hamilton Depression Rating Scale score of 26.79 ±â€¯4.01). Serum and plasma BDNF (sBDNF, pBDNF) levels were assessed at nine time-points before, during, and after acute ECT series. Data were analysed using linear regression and linear mixed models, which were adjusted for multiple comparisons via Bonferroni correction. Five patients received continuation ECT subsequent to the acute ECT series. In these patients, BDNF levels were assessed before and after each two continuation ECT sessions using Wilcoxon signed-rank tests. RESULTS: Relative to baseline (mean ng/ml ±SD: 24.68 ±â€¯14.40), sBDNF levels were significantly higher 1 day (33.04 ±â€¯14.11, p = 0.013, corrected), 1 week (37.03 ±â€¯10.29, p < 0.001, corrected), and 1 month (41.05 ±â€¯10.67, p = 0.008, corrected) after the final ECT session, while pBDNF levels did not significantly differ (p > 0.1). Furthermore, our results indicated that sBDNF levels increased after each continuation ECT session. There was no significant association between sBDNF levels and clinical parameters or treatment response. CONCLUSION: The absence of an association between changes in sBDNF levels and depressive symptoms challenges the proposed concept of sBDNF/pBDNF as key markers of the effects of ECT.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/terapia , Eletroconvulsoterapia/métodos , Adulto , Idoso , Biomarcadores/sangue , Transtorno Depressivo Maior/psicologia , Eletroconvulsoterapia/tendências , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Plasticidade Neuronal/fisiologia , Resultado do Tratamento
9.
Clin Neuropharmacol ; 42(2): 27-31, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30875343

RESUMO

OBJECTIVES: Despite the effectiveness of electroconvulsive therapy (ECT) in a wide range of psychiatric disorders, the role of memory-enhancing agents in post-ECT cognitive disturbances has remained controversial. In this study, we aimed to assess the effect of donepezil on improving the cognitive performance of patients undergoing ECT. METHODS: In a psychiatry hospital, patients who were admitted for ECT underwent a triple-blind randomized controlled trial. After randomizing the participants into 2 groups, 1 group received ECT with placebo, whereas the other group received ECT plus 5 mg/d donepezil during the ECT period. The patients in both groups were cognitively assessed using the Mini Mental Status Evaluation and Wechsler Memory Scale, 24 hours before ECT and 48 hours after the end of the ECT sessions. RESULTS: The results of Mini Mental Status Evaluation scores did not show any significant difference in memory performance between the 2 groups before and after ECT (F = 0.108, P = 0.743). Moreover, the intervention and placebo groups did not have any significant difference in the scores of the 7 subscales of the Wechsler Memory Scale after ECT (P = 0.07). In addition, the patients on donepezil group tolerated the drug well and did not differ significantly compared with the control group in this regard. CONCLUSIONS: Despite a few evidence confirming the effect of acetylcholinesterase inhibitors in improving cognitive defects related to ECT, this study did not find such an effect in patients under ECT. Further studies are required to reach a clear conclusion.


Assuntos
Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/psicologia , Donepezila/uso terapêutico , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/psicologia , Nootrópicos/uso terapêutico , Adulto , Disfunção Cognitiva/etiologia , Método Duplo-Cego , Eletroconvulsoterapia/tendências , Feminino , Humanos , Masculino , Resultado do Tratamento
11.
Nord J Psychiatry ; 72(7): 471-476, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30359165

RESUMO

PURPOSE: To compare the rate of remission, rate of response, change in depressive symptoms, and adverse effects between repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT). MATERIALS AND METHODS: In this retrospective case-control study, 35 patients treated for depression with rTMS (left dorsolateral prefrontal cortex, 90% observed motor threshold, 10 Hz, 2000 pulses/session, 15 sessions) at Örebro University Hospital, Sweden (cases), were compared with a matched group of 35 patients treated for depression with ECT (controls). Data on controls were obtained from the Swedish National Quality Register for ECT (Q-ECT). Severity of depression was evaluated using the Montgomery-Åsberg Depression rating scale (MADRS). RESULTS: Remission rate was 26% for cases and 43% for controls (p = .3). Response rate was 40% for cases and 51% for controls (p = .63). The median decrease in MADRS was 11 (IQR 3-19) vs. 17 (IQR 6-27; p = .10) for rTMS and ECT, respectively. There was no statistically significant difference in any measure of treatment effect between rTMS and ECT. More than half of the patients of the rTMS group experienced scalp discomfort and 11% of the ECT group had memory disturbances. CONCLUSIONS: All measures of therapeutic efficacy were numerically inferior in the rTMS group compared to the ECT group. The differences were not statistically significant, probably because the sample size was small. More studies are required to find the optimal place for rTMS within the Swedish health care system. Such studies could be facilitated by inclusion of rTMS in the Q-ECT.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/terapia , Eletroconvulsoterapia/tendências , Estimulação Magnética Transcraniana/tendências , Adulto , Idoso , Estudos de Casos e Controles , Transtorno Depressivo Maior/epidemiologia , Eletroconvulsoterapia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão/métodos , Estudos Retrospectivos , Suécia/epidemiologia , Estimulação Magnética Transcraniana/métodos , Resultado do Tratamento
12.
Psychiatr Clin North Am ; 41(3): 341-353, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30098649

RESUMO

The current practice of electroconvulsive therapy (ECT) has evolved over several decades with the implementation of safer equipment and advancement of techniques. In addition, modifications in the delivery of ECT, such as the utilization of brief and ultrabrief pulse widths and individualization of treatment parameters, have improved the safety of ECT without sacrificing efficacy. This article aims to provide psychiatrists with a balanced, in-depth look into the recent advances in ECT technique as well as the evidence of ECT for managing depression in special populations and patients with comorbid medical problems.


Assuntos
Transtorno Depressivo Maior/terapia , Transtorno Depressivo Resistente a Tratamento/terapia , Eletroconvulsoterapia , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/métodos , Eletroconvulsoterapia/normas , Eletroconvulsoterapia/tendências , Humanos
13.
Psychiatr Clin North Am ; 41(3): 515-533, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30098662

RESUMO

Trends in brain stimulation include becoming less invasive, more focal, and more durable with less toxicity. Several of the more interesting new potentially disruptive technologies that are just making their way through basic and sometimes clinical research studies include low-intensity focused ultrasound and temporally interfering electric fields. It is possible, and even likely, that noninvasive brain stimulation may become the dominant form of brain treatments over the next 20 years. The future of brain stimulation therapeutics is bright.


Assuntos
Encéfalo , Terapia por Estimulação Elétrica/métodos , Eletroconvulsoterapia/métodos , Transtornos Mentais/terapia , Terapias Somáticas em Psiquiatria/métodos , Estimulação Magnética Transcraniana/métodos , Terapia por Ultrassom/métodos , Encéfalo/fisiopatologia , Terapia por Estimulação Elétrica/normas , Terapia por Estimulação Elétrica/tendências , Eletroconvulsoterapia/normas , Eletroconvulsoterapia/tendências , Humanos , Terapias Somáticas em Psiquiatria/normas , Terapias Somáticas em Psiquiatria/tendências , Estimulação Magnética Transcraniana/normas , Estimulação Magnética Transcraniana/tendências , Terapia por Ultrassom/normas , Terapia por Ultrassom/tendências
14.
J Clin Psychopharmacol ; 38(5): 502-504, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30106881

RESUMO

BACKGROUND: Few therapeutic options are available for patients with electroconvulsive therapy-resistant major depressive disorder (ECT-r MDD), leaving a substantial proportion of this population beyond treatment possibilities. The combination of monoamine oxidase inhibitors and tricyclic antidepressants could be a potential strategy for managing ECT-r MDD, and the specific association of amitriptyline and tranylcypromine may offer additional tolerability advantages. Although promising, in our knowledge, no studies have examined until now the effectiveness of this combination in ECT-r MDD. METHODS: We report a retrospective cohort of 31 patients with ECT-r MDD treated in an open-label fashion with the combination of amitriptyline and tranylcypromine. RESULTS: Overall, 80.6% of the sample met response criteria at the end of the first 12 weeks of treatment. Seventy-six percent (19 of 25) of the responders were followed for a mean of 9.37 ± 3.86 years. During this follow-up period, none of the patients had a recurring depressive episode. The combination was well tolerated, whereas minor adverse effects were common, and no severe or life-threatening events were reported throughout the study. CONCLUSIONS: These findings indicate that the combination tranylcypromine and amitriptyline is a potentially safe and effective candidate for future investigation in the treatment and long-term maintenance of ECT-r MDD.


Assuntos
Amitriptilina/administração & dosagem , Antidepressivos/administração & dosagem , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/psicologia , Eletroconvulsoterapia , Tranilcipromina/administração & dosagem , Adulto , Antidepressivos Tricíclicos/administração & dosagem , Estudos de Coortes , Transtorno Depressivo Resistente a Tratamento/diagnóstico , Quimioterapia Combinada , Eletroconvulsoterapia/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
15.
Nervenarzt ; 89(11): 1248-1253, 2018 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-29971490

RESUMO

There are no rational reasons why electroconvulsive therapy (ECT) should not be subject to the same criteria in its clinical application as any other treatment in medicine. Associations referring to historical events and their presentation in the media do not provide convincing arguments against the clinical use of ECT. In order to offer ECT to patients, scientifically solid evidence with respect to its clinical results must be available. As this scientific evidence is clearly given, ECT must be offered to the patients. A well-informed, reflected medicine must not withhold an effective treatment like ECT from the patients and medicine should not be influenced by associations but only by scientific evidence, even though the exact mechanisms of action of ECT are not known in detail. The image of ECT has clearly improved during the last decades thereby increasing the hope that unjustified arguments against ECT will lose their impact.


Assuntos
Eletroconvulsoterapia , Medicina , Eletroconvulsoterapia/normas , Eletroconvulsoterapia/tendências , Liberdade , Humanos , Medicina/normas , Medicina/tendências
16.
Curr Opin Anaesthesiol ; 31(4): 453-458, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29870425

RESUMO

PURPOSE OF REVIEW: Electroconvulsive therapy (ECT) as a treatment option in psychiatry is advancing day by day. This review discusses new advancements in ECT with regards to anesthetic variables, stimulus, and response variables along with their impact on clinical outcomes. RECENT FINDINGS: Anesthetic variables influence clinical efficacy and patient tolerance of ECT. Although etomidate or a ketamine-propofol combination may be the first choice for many clinicians, the search for ideal induction agent continues. Dexmedetomidine, remifentanil, or ketamine may aid in augmentation of ECT; however, they are not recommended routinely. A systematic procedure for hyperventilation of the patient has been shown to have clinical repercussions. Optimizing anesthesia-ECT time interval (ASTI) has a significant impact on the success of the procedure. BIS monitoring alone cannot be relied upon for timing stimulus. High-dose brief pulse right unilateral ECT represents an acceptable first-line form of treatment, though there is currently no 'gold standard'. Other stimulus variations such as focal electrically administered seizure therapy, individualized low-amplitude seizure therapy, magnetic seizure therapy, left unilateral and left anterior right temporal electrode placements are explored to reduce memory effects. EEG ictal indices may be relied upon for seizure adequacy, and therefore may be used to both guide treatment and predict the outcome of the procedure. SUMMARY: Modern ECT is streamlined by augmentation with drugs, hyperventilation, optimizing anesthesia-ECT time interval, and various stimulus parameters guided by seizure adequacy markers.


Assuntos
Anestesia/métodos , Anestésicos Intravenosos/administração & dosagem , Eletroconvulsoterapia/métodos , Transtornos Mentais/terapia , Adjuvantes Anestésicos/administração & dosagem , Monitores de Consciência , Combinação de Medicamentos , Eletroconvulsoterapia/tendências , Humanos , Monitorização Neurofisiológica/instrumentação , Monitorização Neurofisiológica/métodos , Respiração Artificial/métodos , Convulsões/diagnóstico , Convulsões/etiologia , Fatores de Tempo , Resultado do Tratamento
17.
Psychiatry Res ; 265: 355-359, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29803951

RESUMO

AIMS: We reviewed studies that reported speed of antidepressant response to electroconvulsive therapy (ECT) in both bipolar depression (BPD) and major depressive disorder (MDD). METHODS: We identified English language reports allowing this comparison. RESULTS: Ten studies met our criteria. Four reported significantly faster response in BPD and in one there was trend for faster response. None reported evidence for slower response in BPD. CONCLUSION: The findings support further study of speed of response to ECT in BPD.


Assuntos
Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Eletroconvulsoterapia/métodos , Adulto , Idoso , Antidepressivos/uso terapêutico , Transtorno Bipolar/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Eletroconvulsoterapia/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
18.
Brain Stimul ; 11(4): 860-862, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29643022

RESUMO

BACKGROUND: It is not known whether results of clinical research in ECT can be used to guide treatment decisions for those having involuntary ECT, who are not represented in trial populations. OBJECTIVE: We aimed to compare courses of involuntary ECT with matched voluntary ECT courses in terms of clinical and demographic factors, treatment requirements, and outcomes. METHOD: We performed a retrospective case-control study examining a five-year sample of involuntary ECT courses and an age-, gender- and time-matched voluntary ECT control sample. RESULTS: We examined 48 involuntary and 96 control voluntary ECT courses. While groups differed at baseline in terms of diagnosis, illness severity and illness characteristics, there were no differences in treatment outcomes after ECT or six-month readmission rates. CONCLUSION: Our findings suggest that research on capacitous ECT patients is applicable to those having involuntary ECT.


Assuntos
Eletroconvulsoterapia/métodos , Tratamento Psiquiátrico Involuntário/métodos , Transtornos Mentais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Eletroconvulsoterapia/tendências , Feminino , Humanos , Tratamento Psiquiátrico Involuntário/tendências , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
19.
Aust J Gen Pract ; 47(3): 122-125, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29621842

RESUMO

BACKGROUND: Transcranial magnetic stimulation (TMS)is a treatment for major depressive disorder that is otherwise resistant to treatment. Although world-leading research in TMS has been conducted in Australia, where it has had some availability for two decades, there is limited familiarity with the treatment in the general medical community. Availability, however, is increasing. OBJECTIVE: The aim of this article is to inform general practitioners of some scientific and practical aspects of TMS treatment. DISCUSSION: In TMS, an electromagnetic apparatus is used to generate small electric currents in targeted regions of the cortex. Anaesthesia is not required, patients remain conscious and there are no seizure or memory problems. TMS is a first-line treatment for treatment-resistant depression. Current evidence indicates that TMS-induced remission is associated with normalisation of connectivity in cortical-subcortical networks.


Assuntos
Transtorno Depressivo Maior/terapia , Estimulação Magnética Transcraniana/métodos , Austrália , Transtorno Depressivo Resistente a Tratamento/terapia , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/tendências , Humanos , Estimulação Magnética Transcraniana/efeitos adversos , Estimulação Magnética Transcraniana/tendências , Resultado do Tratamento
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