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Electroconvulsive Therapy01:30

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
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Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
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Electroconvulsive therapy services during COVID-19 pandemic.

Rohini M Surve1, Preeti Sinha2, Sachin P Baliga2

  • 1Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.

Asian Journal of Psychiatry
|April 12, 2021
PubMed
Summary

Electroconvulsive therapy (ECT) is vital for severe mental illness, even during COVID-19. This review details safe practices for continuing ECT services amid the pandemic, ensuring patient care.

Keywords:
AnesthesiaCOVID-19ECT practicePersonal protective equipment

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Area of Science:

  • Psychiatry
  • Neurology
  • Infectious Disease Epidemiology

Background:

  • The COVID-19 pandemic significantly disrupted electroconvulsive therapy (ECT) services globally, often classifying it as elective and deprioritizing it.
  • Concerns regarding infection transmission, resource limitations, and anesthesiologist shortages due to COVID-19 management further impacted ECT availability.
  • Despite challenges, ECT remains a critical, life-saving intervention for severe mental illnesses, particularly when rapid response is needed for suicidality or catatonia.

Purpose of the Study:

  • To review and synthesize literature on maintaining electroconvulsive therapy (ECT) services during the COVID-19 pandemic.
  • To outline essential modifications and protocols for safe ECT administration in a pandemic setting.
  • To provide practical insights and experiences for uninterrupted ECT service delivery.

Main Methods:

  • A narrative review of existing literature on ECT practice during the COVID-19 pandemic.
  • Compilation of data on screening and testing protocols, personal protective equipment (PPE) usage, ECT suite modifications, electrical stimulus settings, and anesthesia techniques.
  • Inclusion of institutional experiences from the authors' practice.

Main Results:

  • The review details necessary adaptations for ECT services, including stringent screening, appropriate PPE, modified ECT suites, and adjusted anesthesia techniques.
  • Guidelines are provided for safe electrical stimulus settings during the pandemic.
  • The authors share practical experiences, offering a blueprint for other institutions.

Conclusions:

  • Continuation of electroconvulsive therapy (ECT) services is crucial during the COVID-19 pandemic due to increased psychiatric distress and the procedure's life-saving nature.
  • Implementing specific safety protocols and modifications ensures the safe and uninterrupted delivery of ECT.
  • This review serves as a guide for healthcare facilities to manage ECT services effectively and safely during health crises.