Classics in ECT: Use of ECT in Suicidal Patients: Frankel in the American Journal of Psychotherapy

"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 major depressive illness. In the absence of such affective illness, understanding and skilled psychotherapy are likely to be more effective. Antidepressant medication and ECT should be administered within a supportive, watchful, and compassionate setting.

The pdf is here.

And from the text:

First off, here's an ECT article in a psychotherapy journal, pretty rare stuff. Like most of Frankel's contributions, it is thoughtful and very well written. The overview of ECT that serves as the introduction is excellent; perhaps the most interesting aspect of the piece is the section (above) on when NOT to use ECT. I recommend a full read of this classic to all ECT healthcare professionals, ~ 10 minutes.