Background: Electroconvulsive therapy (ECT) is a vital treatment strategy for psychiatric patients, and cancellation of the procedure negatively impacts the recovery process. However, it may happen due to the lack of optimal conditions at admission. Methods: This retrospective study occurred at Shafa Hospital, an academic center affiliated with the Guilan University of Medical Sciences (GUMS). The ECT anesthesia team developed an ECT patient preparation checklist, which was shared with psychiatrists. The rate and some related factors of case cancellation were compared between the two years before presenting the checklist, from May 2019 to May 2020, and the next year, from June 2020 to May 2021. The patients’ files were reviewed, and the required information was documented. Results: One hundred fifty-one cancellations were recorded during the two years of study, 82 cases in the first year and 69 in the second year. The most common reason for the cancellation was inadequate consultations followed by abnormal lab tests. In comparing the number of cancellations between the two years, before and after the checklist was provided, no significant difference was observed in terms of age (P = 0.288), gender (P = 0.24), psychiatric disorder (P = 0.399), and the number of ECT sessions (P = 0.36). However, the number of cancellations due to incomplete consultation significantly decreased after developing the checklist (P = 0.049), while unstable hemodynamics and changing patients’ conditions on an intended day also increased (P = 0.024). Residency visits did not significantly affect the number of cancellations over 2 years (P = 0.139). Conclusions: This study concluded that preparing ECT patients according to the checklist led to better conditions and fewer cancellations. However, preventable causes still exist.

Introduction/ObjectivesIn addition to cognitive decline, one of the most important problems for caregivers of patients with Alzheimer's is neuropsychiatric symptoms (NPS). This study aimed to evaluate the NPS in patients with Alzheimer's disease (AD) and investigate its relationship with caregiver burden (CB).MethodsIn a cross-sectional study of 85 patients with AD referred to Shafa Hospital in Rasht and their caregivers in 2020, information was collected using a demographic questionnaire, Neuropsychiatric Inventory Questionnaire (NPI-Q), and the Caregiver Burden Inventory (CBI). Data were analyzed by Spearman correlation, t-test, and linear regression, with SPSS version 22.ResultsThe mean age of the patients and their caregivers were 74.95 ± 8.87 years and 43.98 ± 11.38 years, respectively. The mean total score of NPS in patients with AD was 44.25 (0–144) and the mean CB score was 36.27 (0–96), which was a moderate level. According to the results, 91% of patients had apathy, while happiness/euphoria was reported as the most uncommon symptom. In addition, there was a significant relationship between the score of NPS and CB (r = 0.542, P < 0.0001), as well as all its sub-components, time-dependence burden with more correlation (r = 0.509, P < 0.0001), and social burden with less correlation (r = 0.352, P < 0.001). NPS, hallucination, aberrant motor behavior (AMB), delusion, and depression were most correlated with CB. Also, the mean score of CB was significantly higher in women than in men (P = 0.045). Living in a rural area had a significant relationship with NPS score (P = 0.026). Also, linear regression showed that with increasing 1 year of patients' age, the mean score of patient's NPS decreased by 0.374 (P = 0.048).ConclusionNeuropsychiatric symptoms, especially hallucination, aberrant motor behavior (AMB), delusion, and depression were associated with caregiver burden. Apathy was the most common symptom in patients with AD.