ÖZET:Dirençli obsesif kompulsif bozuklukta EKT EKT, baz› psikiyatrik bozukluklar›n tedavisinde tek bafl›na ya da di¤er tedavilerle birlikte kullan›labilen bir tedavi seçene¤i olarak kabul edilmektedir. OKB'de EKT kullan›m›n› bildiren çok az say›da olgu sunumu olmakla birlikte, s›kl›k-la depresyonla birlikte görülen ve tedaviye yan›t vermeyen OKB'de endike olabilmektedir. Bu yaz›da EKT ile baflar›yla tedavi edilen dirençli iki OKB olgusu tart›fl›ld›. Olgu 1, 37 yafl›nda, tedaviye dirençli OKB tan›s› konan kad›n hastayd›. Yüksek doz çeflitli SSGE (Spesifik serotonin gerial›m engelleyicileri)'nin atipik antipsikotiklerle kombinasyonu etkisizdi. Olgu 2, 43 yafl›nda kad›n hastayd›. Yüksek doz çeflitli antidepresanlarla birlikte anksiyolitikler ve risperidon ile tedavi edildi ve tedaviye yan›ts›zd›. Her iki olguda da EKT ile klinik iyileflme sa¤land›. ‹leri araflt›rmalar, hangi OKB olgular›-n›n EKT'ye uygun olaca¤›n› aç›klayabilir. ECT use in refractory obsessive-compulsive disorder Either alone or in combination with other forms of treatment, electroconvulsive therapy (ECT) is accepted as a choice of treatment for some psychiatric disorders. Although there are relatively few case reports specifically for use of ECT in obsessive-compulsive disorder (OCD), severe and intractable OCD is often associated with severe depression for which ECT may be indicated. The aim of this article is to discuss two cases of treatment refractory OCD which were successfully treated with ECT. Case 1 was a 37 year-old female patient. She was diagnosed with treatment refractory OCD. High doses of various selective serotonin reuptake inhibitors (SSRIs) in combination with atypical antipsychotics were ineffective. Case 2 was a 43 year-old female patient. She also was treated with numerous antidepressants at high doses with concomitant anxiolytics and risperidone, and was not responsive to any of them. She was diagnosed with refractory OCD, as well. Clinical improvement was obtained in both cases with ECT. Further research may clarify which OCD patients are appropriate candidates for ECT.

This paper addresses the limitations of Modern Money Theory (MMT) as a guide to development policy. We explore two main questions on this topic: whether policies championed by MMT advocates (i) ought to be implemented in low- and middle-income economies and (ii) can be implemented. In relation to the first question, we argue that the MMT literature mischaracterises the essence of the development challenge for low- and middle-income economies. Our argument is that the chief long-run growth challenge faced by developing countries concerns structural transformation rather than general aggregate demand insufficiency. We use several formal representations of the consumption–investment trade-off in growth theory, found in the Harrod–Domar growth model, the Feldman–Mahalanobis model and Kalecki’s 1963 growth model to illustrate this point. Concerning the second question, we argue that even if MMT had the correct diagnosis of the principal growth challenge faced by developing countries, its chief policy recommendations would likely be counter-productive if implemented outside of select advanced economies. We draw from the international economics literature on currency hierarchy and exchange rate volatility to illustrate this point.

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