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Related Concept Videos

Electroconvulsive Therapy01:30

Electroconvulsive Therapy

25
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...
25

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Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
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Palliative Electroconvulsive Therapy: A Descriptive Cohort Study.

Gregg A Robbins-Welty1, Ryan D Slauer2, Madeline M Brown3

  • 1Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Journal of the Academy of Consultation-Liaison Psychiatry
|December 11, 2024
PubMed
Summary

Palliative electroconvulsive therapy (PECT) improved psychiatric symptoms and quality of life in patients with serious medical illnesses. This study highlights PECT

Keywords:
catatoniaelectroconvulsive therapyhospicemajor neurocognitive disorderpalliative careserious mental illness

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Area of Science:

  • Psychiatry
  • Palliative Care
  • Geriatrics

Background:

  • Palliative care (PC) is crucial for patients with serious medical illnesses impacting quality of life (QOL).
  • Electroconvulsive therapy (ECT) is a standard treatment for psychiatric conditions, sometimes co-occurring with serious medical illnesses.
  • The application of palliative ECT (PECT) in this complex patient population remains understudied.

Purpose of the Study:

  • To retrospectively review the indications, outcomes, and treatment regimens of palliative ECT (PECT).
  • To evaluate the effectiveness and safety of PECT in patients with serious medical illnesses.
  • To identify patient groups who may benefit from PECT.

Main Methods:

  • A descriptive retrospective cohort study was conducted.
  • Included patients had an ECT consultation and either a PC consultation or do-not-attempt-resuscitation (DNAR) status.
  • Data were collected between 2018 and 2023.

Main Results:

  • Twenty-one patients received PECT; 31 met inclusion criteria.
  • Common indications included catatonia (64.5%) and treatment-resistant depression (35.5%).
  • All 21 patients who received PECT showed psychiatric symptom improvement, with 5 (23.8%) experiencing reduced mortality risk.
  • Five patients initially diagnosed with major neurocognitive disorder (MNCD) improved with PECT, with diagnoses revised to depression-related cognitive dysfunction.
  • Eight patients with comorbid MNCD showed a mean Montreal Cognitive Assessment (MoCA) improvement of 5 points.

Conclusions:

  • PECT is beneficial for patients with serious medical illnesses, improving QOL and reducing suffering.
  • It is effective in cases of life-threatening psychiatric illness, terminal illness with refractory psychiatric conditions, and diagnostic uncertainty regarding MNCD.
  • Cross-specialty collaboration between consultation-liaison psychiatry and palliative care is crucial for optimal patient management.