Article

Unilateral electro-convulsive therapy.

The Journal of mental science 02/1958; 104(434):221-7. DOI: 10.1192/bjp.104.434.221
Source: PubMed
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    ABSTRACT: The results of the Nottingham electroconvulsive therapy (ECT) trial were examined to compare the response of patients aged 60 and over to real versus simulated ECT. The outcome of patients given real compared to simulated ECT was significantly better immediately after six study treatments. Unilateral ECT was an effective as bilateral treatment. The small number of patients studied did not allow for definitive conclusions on whether patients responded sooner to bilateral relative to unilateral treatment.
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    ABSTRACT: 100 therapieresistente, vorwiegend endogen-depressive, Patienten, die durchschnittlich 41 Tage erfolglos mit Psychopharmaka vorbehandelt worden waren, wurden in einer Doppelblind-Studie uni- und bilateral mit Elektrokrampf behandelt. Die Wirksamkeit wurde erfat durch: 1. Klinische Einschtzung des Therapieerfolges, 2. AMP-Dokumentation, 3. Hamilton-Skala zur Messung depressiver Symptomatik, 4. Befindlichkeitsskala nach von Zerssen; die Nebenwirkungen durch: 1. Vigilanzprfung (Flimmerverschmelzungsfrequenz und tachistoskopische Schwellenbestimmung), 2. Gedchtnistests fr visuelles und verbales Behalten, 3. Konzentrationsleistungs-Test, 4. Begriffsbildungs-Test, 5. Benton-Test.Ergebnisse: Die klinische Wirksamkeit der beiden Methoden ist gleich. Bei der unilateralen Gruppe kommt es signifikant weniger zum Auftreten psychoorganischer Durchgangssyndrome und zu einer geringeren Beeintrchtigung des Gedchtnisses fr verbales Behalten und der Konzentrationsleistung. Die Summation der Nebenwirkungen ist signifikant geringer. Vom Applikationsmodus nicht beeinflut werden Vigilanz, Gedchtnisleistung fr visuell dargebotenes Material und Begriffsbildung.Eine Woche nach Abschlu der Behandlung hatten sich beide Gruppen in der Vigilanz und im optischen Gedchtnis signifikant verbessert im Vergleich zu den Ergebnissen vor Beginn der EKTH; die unilaterale Gruppe darber hinaus noch im verbalen Gedchtnis und in der Konzentrationsleistung.In a double-blind study 100 patients were treated either with conventional ECT or with unilateral ECT. The majority suffered from depressive illness, mainly endogenous depression. On average, they were hospitalized 41 days and unsuccessfully treated with antidepressants and other psychoactive drugs before ECT was given as a last treatment resort.ECT efficiency was evaluated by: (1) clinical evaluation, (2) AMP documentation, (3) the Hamilton Rating Scale for Depression, and (4) the von Zerssen Mood Scale. Side effects were evaluated by a test (1) for vigilance (tachistoscopic threshold), (2) for verbal and visual memory, (3) for performance, (4) for concept formation, and (5) the Benton test.Results: There was no difference in clinical efficiency between the two methods. As for side effects, unilateral ECT produced fewer organic brain syndromes and less impairment of verbal memory and performance. Total side effects were significantly less.There was no significant difference between the two methods with regard to vigilance, visual memory, and concept formation.One week after ECT, in both groups there was a significant increase in vigilance and visual memory in comparison to the results before ECT; the unilateral group also showed significant increase in verbal memory and concentration.
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