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"En Bloc" ECT in Denmark: New Register Study in Nordic Journal of Psychiatry

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Out on PubMed, from investigators in Denmark and the USA is this study: The use of  electroconvulsive  therapy (ECT) en bloc in Denmark: a nationwide register-based study. Pedersen MI, Salagre E, Kellner CH, Rohde C, Østergaard SD. Nord J Psychiatry. 2022 Nov 7:1-7. doi: 10.1080/08039488.2022.2142279. Online ahead of print. PMID:  36344233 The abstract is copied below: Objective: Electroconvulsive therapy (ECT) en bloc is defined as ECT administered on 2-3 consecutive days. In Denmark, ECT en bloc is recommended for severe conditions such as catatonia, treatment-resistant mania/psychosis, or imminent risk of suicide. To our knowledge, there are no recent reports on the use of ECT en bloc in clinical practice. Here, we provide such a report. Methods: We characterized the use of ECT en bloc in the period from 2006-2019 based on data from Danish national registers. Furthermore, we compared mortality rates between patients receiving ECT en bloc and patients receiving standard regimen ECT (
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ECT in Thailand: Nationwide Survey

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Out on PubMed, from authors in Thailand, is this article: Electroconvulsive Therapy Practice in Thailand: A Nationwide Survey. Kittayarak K, Ittasakul P. Neuropsychiatr Dis Treat. 2022 Oct 31;18:2477-2484. doi: 10.2147/NDT.S385598. eCollection 2022. PMID:  36338515 The abstract is copied below: Objective: To determine the characteristics of electroconvulsive therapy (ECT) practice in Thailand. Methods: A cross-sectional survey of ECT practice in Thailand was conducted. A questionnaire was sent to all 34 hospitals providing ECT services nationwide. ECT staff of each hospital were asked to complete the questionnaire. Results: All 34 hospitals responded to the survey. The most common diagnosis was schizophrenia (5,958 patients/year), followed by bipolar disorder (982 patients/year) and major depressive disorder (869 patients/year). Brief pulse device was used in all hospitals. Bitemporal ECT was the most common type of electrode placement (88.2%), followed by bifrontal (44.1%) and right u
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Blogger on Hiatus November 23-28

I   will be on  hiatus  from November 23-28, resuming on the 29th. Please feel free to review prior blog posts, and don't forget to check PubMed.
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Cerebral Perfusion, Efficacy and Tolerability of ECT: New Study From Denmark

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Out on PubMed, from investigators in Denmark, is this study: Cerebral perfusion is related to antidepressant effect and cognitive side effects of  Electroconvulsive  Therapy. Gbyl K, Lindberg U, Wiberg Larsson HB, Rostrup E, Videbech P. Brain Stimul. 2022 Nov 1:S1935-861X(22)00230-3. doi: 10.1016/j.brs.2022.10.007. Online ahead of print. PMID:  36332891 The abstract is copied below: Background: The mechanisms underlying the antidepressant effect and cognitive side effects of Electroconvulsive Therapy (ECT) remain elusive. The measurement of cerebral perfusion provides an insight into brain physiology. Objective: We investigated ECT-related perfusion changes in depressed patients and tested whether these changes correlate with clinical effects. Methods: A sample of 22 in-patients was examined at three time points: 1) within two days before, 2) within one week after, and 3) six months after an ECT series. Cerebral perfusion was quantified using arterial spin labeling magnetic resonance i
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ECT Anesthesia: New Review in Advances in Anesthesia

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Out on PubMed, from an anesthesiologist in Seattle, is this review: Contemporary Anesthetic Evaluation and Management for Electroconvulsive Therapy. Salinas FV. Adv Anesth. 2022 Dec;40(1):201-221. doi: 10.1016/j.aan.2022.07.005. PMID:  36333048   Review. The abstract is copied below: Electroconvulsive therapy (ECT) is a medical treatment most often used in patients with severe major depression that has not responded to other treatments. ECT is also indicated for patients with other severe psychiatric conditions, including bipolar disorder, schizophrenia, schizoaffective disorders, catatonia, and neuroleptic malignant syndrome. Contemporary "modified ECT" involves inducing general anesthesia with neuromuscular blockade before inducing the therapeutic seizure. The goal of this review is to combine an evidence-based update with the experience of the author's institution to provide a practical approach to anesthetic care for the patient undergoing ECT. Keywords: Electroconvul
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Classics in ECT: Use of ECT in Suicidal Patients: Frankel in the American Journal of Psychotherapy

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"Classics in ECT" brings you this article by Dr. Fred Frankel in the American Journal of Psychotherapy, in 1984: The use of electroconvulsive therapy in  suicidal  patients. Frankel FH. Am J Psychother. 1984 Jul;38(3):384-91. doi: 10.1176/appi.psychotherapy.1984.38.3.384. PMID:  6486285 The abstract is copied below: Publications on the subjects of ECT and suicide stress the importance of ECT as a valuable treatment in appropriately selected cases of suicidal ideation or attempted suicide. There is no direct correlation between the degree of suicidality and the usefulness of ECT. In the management of cases with major affective disorder, particularly those showing delusions and vegetative signs, ECT should be considered early in the treatment. The presence of the potential for suicide provides an added incentive. However, suicidal threats or attempts on the part of patients with severe personality disorders are not likely to respond to ECT unless the picture is complicated by m
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Classics in ECT: Response to First ECT As a Predictor of Outcome, Indian Journal of Psychiatry, 1998

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"Classics in ECT" brings you this study from 1998, in the Indian Journal of Psychiatry: Response to first ect in depression : a predictor of outcome. Gupta N, Avasthi A, Kulhara P. Indian J Psychiatry. 1998 Oct;40(4):322-6. PMID:  21494495   Response to first ECT in depression and its value as a predictor of response to ECT is a poorly researched subject. Twenty-two antidepressant-free patients of severe depression (ICD - 10) were administered a course of 6 ECTs using bilateral sine-wave electrical stimulation with serial assessments on Hamilton Depression Rating Scale (HDRS). Using 'a priori' definition for 'good response' (≥ 60% reduction is baseline HDRS scores) patients were grouped and analysed. The reduction in HDRS scores after first ECT was significantly greater for Good Responders (GR) in comparison to 'Poor responders'. It appeared that ≥ 9% reduction in baseline HDRS scores after the first ECT was associated with 'Good Response'. Th
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