Analysis of indications for electroconvulsive therapy in the hospitalized psychiatric patients

master's thesis

• Title (croatian): Analiza indikacija za elektrokonvulzivnu terapiju u hospitaliziranih psihijatrijskih bolesnika
• Author: Ana Stručić
• Mentor: Alma Mihaljević-Peleš (mentor)
• Committee member: Marina Šagud (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Alma Mihaljević-Peleš (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

All around the world guidelines and indications for electroconvulsive therapy (ECT) differ. However, ECT is considered the most effective in treating depression, schizophrenia, mania, suicidality and treatment resistance. The goal of this research was to analyze ECT indications from medical history of the hospitalized patients in the time period 2010-2017. There were 213 patients treated with ECT, previously diagnosed with schizophrenia, depression or bipolar disorder. The leading ECT indication was treatment resistance associated with already mentioned diagnoses, followed by suicidality, catatonia and neuroleptic malignant syndrome. Men were significantly younger than women receiving the first ECT treatment and more often they had resistant positive schizophrenia symptoms. Women more often had negative resistant schizophrenic symptoms and mood disorders as an indication. Within one year after receiving ECT, 1/3 of the patients were rehospitalized without differences in indications. Therapy resistance is gaining more importance as an ECT indication. Further studies will provide a better insight into ECT as a treating method, better understanding of the treatment, targeted and timely set indications as well as neutralization of controversies around ECT.

Abstract (croatian)

Diljem svijeta smjernice i indikacije za elektrokonvulzivnu terapiju (EKT) variraju, a EKT se smatra učinkovitim u liječenju depresije, shizofrenije, manije, suicidalnosti i terapijske rezistencije. Cilj ovog istraživanja bio je analizirati indikacije za EKT u hospitaliziranih bolesnika u periodu od 2010. do 2017. godine iz medicinske dokumentacije. Liječenje EKT-om primilo je 213 bolesnika s dijagnozom shizofrenije, depresije ili bipolarnog poremećaja. Vodeća indikacija za aplikaciju EKT-a bila je terapijska rezistencija povezana s navedenim dijagnozama, a rjeđe suicidalnost, katatonija i maligni neuroleptički sindrom. Muškarci su bili značajno mlađi od žena prilikom prve aplikacije EKT-a i češće su imali indikaciju rezistentnih pozitivnih simptoma shizofrenije. Bolesnice su češće imale indikaciju rezistentne negativne shizofrenije i poremećaja raspoloženja. Unutar godine dana nakon EKT-a, ponovo je hospitalizirana trećina bolesnika, bez razlika između indikacija. Terapijska rezistencija dobiva sve veći značaj kao indikacija za liječenje EKT-om, uz tradicionalne primarne indikacije. Istraživanja primjene EKT-a u liječenju psihičkih bolesti omogućit će bolje razumijevanje ove metode liječenja, ciljano i pravovremeno postavljanje indikacija te smanjivanje kontroverzi povezanih s ovom metodom liječenja.

• Keywords: ECT; indications for ECT; pharmacotherapy resistance; psychosis; suicidality
• Keywords (croatian): EKT; indikacije za EKT; rezistencija na psihofarmake; psihoza; suicidalnost
• Language: english
• URN:NBN: urn:nbn:hr:105:292394
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-29 11:14:11