Electroconvulsive Therapy in Women: A Retrospective Study from a Mental Health Hospital in Turkey

Abstract

The aim was to evaluate the clinical profile and effectiveness of ECT in women. A retrospective chart review was carried out to identify female patients who had received ECT during the period September 2013-February 2015. Details regarding their sociodemographic, clinical, and treatment data were extracted from these records for the present study. The total number of patients, admitted to our psychiatry inpatient clinic during the survey period, was 802. During this period, 26 (3.24 %) female patients received ECT. Patients who received ECT were mostly in age group of 25-44 years (76.9 %). Twenty percent of patients were in the postpartum period. Psychotic disorders (46.1 %) was the most common diagnosis for which ECT was used, followed by bipolar affective disorder, current episode manic (19.2 %). At the end of ECT courses, 70 % of the patients showed good response with a CGI-I of 1 or 2, and 30 % showed minimal response with a CGI-I score of 3. The most common side effects were post-ECT confusion (15.4 %) and prolonged seizure (11.5 %). This rate of prolonged seizure was higher the rates reported in the literature. The bronchospasm related with remifentanil, post-ECT bradycardia, hypertensive crisis and oligohydramnios were also reported in one case each. ECT is a safe and effective treatment option in women with severe psychiatric disorders and disorders in the perinatal/postpartum period are a major area of ECT use. The female gender may be a contributing factor for the higher rates of prolonged seizure.

Post-Partum Depression- Treatment Update

“…A recent retrospective study, which evaluated catatonia among female with postpartum psychosis in a motherbaby inpatient psychiatry unit, reported the usefulness of ECT in 19 females who did not respond to lorazepam trial [84]. A retrospective study which evaluated the use of ECT in females from Turkey reported that only 3.24% of females admitted to a psychiatric inpatient unit received ECT, of which 20% of ECTs were used during the postpartum period [85]. Previous studies suggests that depression, suicidal tendency, and catatonia are the most common indications for the use of ECT in patients with postpartum psychiatric illnesses [86,87].…”

ECT practice in a research and training hospital

“…tarafýndan Bakýrköy Ruh ve Sinir Hastalýklarý Hastanesinde yapýlan bir çalýþ-mada, tüm psikiyatri baþvurularýnda EKT uygulama oraný %0,58 olarak bulunmuþ, en sýk EKT endikasyonlarý ise sýrasýyla bipolar bozukluk manik epizod (%30,3), þizofreni (%29,5) ve major depresyon (%15,2) olarak belirlenmiþtir (5). Ayný hastanede, hastanede yatan kadýn hastalar arasýnda yapýlan baþka bir çalýþmada ise en sýk EKT endikasyonu psikotik bozukluklar olarak tespit edilmiþtir (6).…”

“…Ülkemizde bu konu ile ilgili Çukurova Üniversitesi ve BRSHH'de yapýlan iki çalýþmada en sýk endikasyon affektif bozukluklar olarak bildirilmiþtir (6,9,10). Ancak BRSHH'de 2008-2010 yýllarý arasýnda yapýlan EKT uygulamalarýný inceleyen bir çalýþmada ise en sýk endikasyon psikotik bozukluklar olarak saptanmýþtýr (11).…”

“…Ülkemizde ve dünyada yapýlan çalýþmalarla paralel olan sonuçlarýmýz EKT'nin baþta þizofreni ve major depresyon olmak üzere ruhsal rahatsýzlýklarda etkili bir tedavi yönte-mi olduðunu göstermiþtir (6,10,15).…”

“…Bu oran Türkiye'de bildirilen oranlardan oldukça düþüktür (6,9,10). Literatürde en sýk gözlenen olumsuz etkiler baþ aðrýsý, konfüzyon ve geçici bellek sorunlarý olarak belirtilmiþtir (26).…”