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Related Experiment Videos

Radiographic screening for ECT: use and usefulness

V Milstein1, M J Milstein, I F Small

  • 1Larue D. Carter Memorial Hospital, Indiana University School of Medicine, Indianapolis 46202, USA.

Convulsive Therapy
|March 1, 1995
PubMed
Summary
This summary is machine-generated.

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Routine use of muscle relaxants and radiologic studies in electroconvulsive therapy (ECT) is common, but pre- and post-ECT imaging rarely reveals clinically significant findings, suggesting potential overuse of these diagnostic procedures.

Area of Science:

  • Neurology
  • Psychiatry
  • Radiology

Background:

  • Electroconvulsive therapy (ECT) is a medical treatment most often used for patients with severe major depression or other psychiatric disorders that have not responded to other treatments.
  • The use of muscle relaxants and radiologic studies in ECT is a practice that varies among clinicians.

Purpose of the Study:

  • To survey the Association for Convulsive Therapy members regarding their practices of using muscle relaxants and radiologic studies for ECT.
  • To evaluate the clinical significance of pre- and post-ECT radiologic findings.

Main Methods:

  • A mail survey was sent to members of the Association for Convulsive Therapy.
  • One hundred eleven completed responses were analyzed, with 40% reporting routine use of pre-ECT spine and skull radiographs.

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  • 57 pre- and post-ECT film pairs were reviewed by a radiologist, and pre-ECT reports were assessed by a psychiatrist.

    • Main Results:

    • 40% of respondents routinely obtained pre-ECT spine and skull radiographs, using 1 to 10 films per patient.
    • Radiologic evaluation of 57 pre- and post-ECT film pairs revealed few clinically significant findings.
    • Psychiatric review of pre-ECT reports indicated that changes in routine ECT procedures were rarely required due to radiographic findings.

    Conclusions:

    • The routine acquisition of pre- and post-ECT radiologic studies appears to yield few clinically significant findings.
    • This suggests a potential for overuse of routine imaging in the context of electroconvulsive therapy.
    • Further investigation into evidence-based guidelines for radiologic imaging in ECT is warranted.