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Abstract
Objectives
Electroconvulsive therapy (ECT) has become useful in psychiatric practice. This study was conducted to describe the clinical practice of ECT, including indications, efficacy, and side effects, in patients treated with modified unilateral or bilateral ECT.
Methods
The clinical records of patients treated with ECT during the period of January 2002 to December 2013 were evaluated retrospectively. A total of 107 patients (83 unilateral and 24 bilateral) were included in the analysis. Diagnostic categories treated were schizophrenia (46.7%), major depression (42.1%), bipolar disorder (9.3%), and obsessive-compulsive disorder (1.9%). Right unilateral or bilateral ECT was administered with brief pulse stimulation using modified ECT. Severity of illness and clinical improvement were measured using the Clinical Global Impressions (CGI) Scale.
Results
A positive response to ECT was found in 56.1% according to response criteria of the CGI-Improvement (CGI-I) score of 1 or 2. Response rates (based on CGI-I ≤2) for schizophrenia, major depression, bipolar disorder, and obsessive-compulsive disorder were 48.0%, 62.2%, 70.0%, and 50.0%, respectively (p=0.42). Although unilateral and bilateral ECT did not differ in rates of response, bilateral ECT resulted in more rapid onset of improvement. Bilateral ECT showed association with more adverse side effects (unilateral 31.3% vs. bilateral 70.8%).
Conclusion
ECT is a highly effective and safe therapeutic option in the treatment of psychiatric illness, particularly in major mood disorder and schizophrenia. The use of ECT in a university hospital psychiatric unit in South Korea reflects similar results to those described in the international literature.
Figures and Tables
Table 2
Demographic and clinical characteristics of responder and non-responder patients by diagnosis
* : The total number was 81 because two patients with obsessive-compulsive disorder were omitted from the analysis due to small numbers. CGI : Clinical Global Impression, CGI-I : Clinical Global Impression-Global Improvement, CGI-S : Clinical Global Impression-Severity of Illness, ECT : Electroconvulsive therapy, M : Mean, N : Number, SD : Standard deviation
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