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Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions: characteristics, indications, and results.

Iancu I, Pick N, Seener-Lorsh O, Dannon P - Neuropsychiatr Dis Treat (2015)

Bottom Line: While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions.There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment).C/M-ECT is safe and effective for chronically hospitalized patients.

View Article: PubMed Central - PubMed

Affiliation: Be'er Ya'akov Mental Health Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

ABSTRACT

Background: While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning.

Methods: We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years) with schizophrenia (n=16) or schizoaffective disorder (n=4) who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised.

Results: Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment). We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant.

Conclusion: C/M-ECT is safe and effective for chronically hospitalized patients. It improves general functioning and reduces verbal aggression and self-harm. More research using other aggression tools is needed to determine its effects and to reproduce our findings in prospective and controlled studies.

No MeSH data available.


Related in: MedlinePlus

Changes in results in Global Assessment of Functioning, Clinical Global Impression-Severity, and OAS scores before and after ECT.Note: Data are shown as the mean ± standard deviation.Abbreviation: ECT, electroconvulsive therapy; OAS, Overt Aggression Scale; GAF, Global assessment of function; CGI-S, Clinical Global Impression-Severity.
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f1-ndt-11-853: Changes in results in Global Assessment of Functioning, Clinical Global Impression-Severity, and OAS scores before and after ECT.Note: Data are shown as the mean ± standard deviation.Abbreviation: ECT, electroconvulsive therapy; OAS, Overt Aggression Scale; GAF, Global assessment of function; CGI-S, Clinical Global Impression-Severity.

Mentions: Subscale scores for aggression towards objects and aggression towards others showed a significant reduction (52% and 59%, respectively, not statistically significant). Subscale scores for verbal aggression (shouting, cursing, threatening) and aggression towards self (eg, itching of the skin, self-hitting, hair pulling, head banging, dropping to the floor) decreased significantly (54% and 63%, respectively). The mean total Overt Aggression Scale (OAS) score fell by 55%, but this was not statistically significant. Mean CGI-S scores decreased following ECT treatment by 39% (not statistically significant). Level of functioning, as measured on the GAF scale, increased significantly by 17% (Table 2 and Figure 1).


Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions: characteristics, indications, and results.

Iancu I, Pick N, Seener-Lorsh O, Dannon P - Neuropsychiatr Dis Treat (2015)

Changes in results in Global Assessment of Functioning, Clinical Global Impression-Severity, and OAS scores before and after ECT.Note: Data are shown as the mean ± standard deviation.Abbreviation: ECT, electroconvulsive therapy; OAS, Overt Aggression Scale; GAF, Global assessment of function; CGI-S, Clinical Global Impression-Severity.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384746&req=5

f1-ndt-11-853: Changes in results in Global Assessment of Functioning, Clinical Global Impression-Severity, and OAS scores before and after ECT.Note: Data are shown as the mean ± standard deviation.Abbreviation: ECT, electroconvulsive therapy; OAS, Overt Aggression Scale; GAF, Global assessment of function; CGI-S, Clinical Global Impression-Severity.
Mentions: Subscale scores for aggression towards objects and aggression towards others showed a significant reduction (52% and 59%, respectively, not statistically significant). Subscale scores for verbal aggression (shouting, cursing, threatening) and aggression towards self (eg, itching of the skin, self-hitting, hair pulling, head banging, dropping to the floor) decreased significantly (54% and 63%, respectively). The mean total Overt Aggression Scale (OAS) score fell by 55%, but this was not statistically significant. Mean CGI-S scores decreased following ECT treatment by 39% (not statistically significant). Level of functioning, as measured on the GAF scale, increased significantly by 17% (Table 2 and Figure 1).

Bottom Line: While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions.There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment).C/M-ECT is safe and effective for chronically hospitalized patients.

View Article: PubMed Central - PubMed

Affiliation: Be'er Ya'akov Mental Health Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

ABSTRACT

Background: While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning.

Methods: We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years) with schizophrenia (n=16) or schizoaffective disorder (n=4) who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised.

Results: Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment). We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant.

Conclusion: C/M-ECT is safe and effective for chronically hospitalized patients. It improves general functioning and reduces verbal aggression and self-harm. More research using other aggression tools is needed to determine its effects and to reproduce our findings in prospective and controlled studies.

No MeSH data available.


Related in: MedlinePlus