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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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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Electroconvulsive Therapy and Death by Suicide.

Bradley V Watts1,2,3, Talya Peltzman2, Brian Shiner1,2

  • 1Department of Psychiatry, Geisel Medical School at Dartmouth College, Hanover, New Hampshire.

The Journal of Clinical Psychiatry
|April 14, 2022
PubMed
Summary

Electroconvulsive therapy (ECT) did not show a decreased risk of suicide death in a recent study. The study found similar suicide mortality rates between patients receiving ECT and a matched control group.

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Area of Science:

  • Psychiatry
  • Neuroscience
  • Public Health

Background:

  • The association between electroconvulsive therapy (ECT) and suicide risk remains unclear, with existing studies often not reflecting current practices.
  • Limited research has examined the impact of a full course of ECT on suicide mortality in contemporary patient populations.

Purpose of the Study:

  • To investigate if an adequate course of electroconvulsive therapy (ECT) is linked to a reduced risk of death by suicide.
  • To analyze suicide mortality rates in patients receiving ECT compared to a matched control group in a present-day sample.

Main Methods:

  • Utilized electronic medical record data from the Department of Veterans Affairs health system (2000-2017).
  • Compared all-cause and suicide mortality between patients undergoing an index course of ECT and a propensity score-matched control group.
  • Analyzed data for 5,157 index ECT courses.

Main Results:

  • Suicide death rates were 137.34 per 10,000 within 30 days and 804.39 per 10,000 within 365 days for the ECT group.
  • Control group suicide death rates were 138.65 per 10,000 within 30 days and 564.52 per 10,000 within 1 year.
  • The relative risk of suicide death at 30 days was 0.96 (95% CI, 0.38-1.55) and at 1 year was 1.38 (95% CI, 0.88-1.87) for the ECT group compared to controls.

Conclusions:

  • The risk of suicide mortality within 30 days and 1 year post-treatment was comparable between patients receiving ECT and the matched control group.
  • This study found no evidence that a course of electroconvulsive therapy reduces the risk of death by suicide.
  • Findings suggest that ECT may not offer protection against suicide mortality in the studied population.