Every second counts: A retrospective case series on patients of a tertiary hospital psychiatry unit who underwent electroconvulsive therapy from September 2015 to August 31, 2016
- Author:
Joyce Ann N. Maglaque
- Publication Type:Journal Article
- Keywords:
Electroconvulsive Treatment
- MeSH:
Humans;
Bipolar Disorder;
- From:
The Philippine Journal of Psychiatry
2020;1(1-2):1-
- CountryPhilippines
- Language:English
-
Abstract:
This research aimed to describe the demographic and clinical presentation over the course of hospital stay of all patients who underwent at least 6 sessions of electroconvulsive therapy (ECT) from September 1, 2015 to August 31, 2016. METHODOLOGY: This was a retrospective case series. After extensive inclusion and exclusion criteria were employed, seven out of the 13 patients given ECT that year were included for this study (n=7). This was comprised of: three (n=3) with MDD, two (n=2) with Bipolar Disorder Most Recent Episode (MRE) Depressed, two (n=2) with schizophrenia spectrum disorders. For these cases, they were all initially recommended to undergo 6 ECT sessions. All underwent the same anesthetic technique, performed by the same anesthesiologist. Comparison of their course during treatment was obtained through chart review and through recorded DSM-5 symptom checker accomplished on their admission, after 4th ECT session, after the last ECT session and 24 hours before discharge. RESULTS: Only cases with MDD were in their early adulthood (n=2) showed reduction of symptoms 24 hours after the 4th ECT session and did not require further sessions or any changes in the placement of the ECT leads. In contrast, two (n=2) of the cases who were women in their late adulthood required a shift from an initial unilateral ECT to bilateral ECT after no improvement was noted in their 4th session, thereby requiring more sessions than planned. Cases with other diagnoses (n=4) also required more sessions than initially planned and did not show improvement in their symptom checkers 24 hours after the 4th ECT session. Findings and how each case compared with current literature on the understanding of ECT and factors such as age, gender, diagnosis, history of psychopathology, lead placement, were further explored in the discussion. CONCLUSION: The study shows that there was significant reduction in symptoms during the course of admission among patients receiving ECT at the tertiary institution of study; however, the course of symptom reduction varied based on several factors. Factors discussed in this study were age, biological sex, history of psychopathology, diagnosis and ECT lead placement. Due to the limited number of cases,, it is recommended for future researchers to compare symptomatology of patients and their clinical course during the duration of ECT treatment for a longer period of time and with a larger sample size in order to arrive at a more generalizable protocol.
