Electroconvulsive therapy: is there a role for treating older patients?

Ramos-García, M.I.; González-Salazar, CF

doi:10.1017/s0959259813000166

Cited by 6 publications

(3 citation statements)

References 119 publications

(109 reference statements)

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“…Other neurological disorders: Other neurological entities found in older patients with catatonia were epidural empyema[ 7 ], progressive supranuclear palsy[ 82 ], frontotemporal lobes atrophy[ 83 ], cerebral Whipple’s disease[ 84 ], Creutzfeld-Jakob disease[ 85 ] and cerebral anoxia after a cardiac arrest[ 86 ].…”

Section: Resultsmentioning

confidence: 99%

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Catatonia in older adults: A systematic review

Jaimes-Albornoz¹,

Pellon-Santamaria²,

Nizama-Vía³

et al. 2022

WJP

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BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated, even though its classification has evolved in recent years. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. The underrecognition of catatonia in older patients is also frequent, and research in this population is scarce. AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings. METHODS Following the PRISMA guidelines, MEDLINE, EMBASE, and PsycINFO databases were searched from inception to December 2021, with a strategy aimed at identifying all articles published on catatonia in older adults. Titles and abstracts were scanned and selected independently by two authors. Papers investigating issues related to catatonia and/or catatonic symptoms in older people, with English abstracts available, were included. References of selected articles were revised to identify other relevant studies. RESULTS In total, 1355 articles were retrieved. After removing duplicates, 879 remained. Of the 879 identified abstracts, 669 were excluded because they did not meet the inclusion criteria. A total of 210 articles underwent full text review, and 51 were eliminated for various reasons. Fourteen more articles were selected from the references. Overall, 173 articles were reviewed: 108 case reports, 35 case series, 11 prospective cohort studies, 6 case-control studies, 3 retrospective cohort studies and 10 reviews. We found several particular aspects of catatonia in this population. Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology. Older patients, compared to younger patients, have a higher risk of developing catatonia with benzodiazepine (BZD) withdrawal, in bipolar disorder, and in the general hospital. Age, together with other risk factors, was significantly associated with the incidence of deep venous thrombosis, neuroleptic malignant syndrome poor outcome, other complications and mortality. Treatment with BZDs and electroconvulsive therapy is safe and effective. Prompt treatment of its cause is essential to ensure a good prognosis. CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology. The risk of developing catatonia in some settings and conditions, as well as of developing complications, is high in this population. Symptomatic treatment is safe and effective, and timely etiologic treatment is fundamental.

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Section: Resultsmentioning

confidence: 99%

“…Its early recognition is important, as it is a potentially deadly syndrome. However, it is highly treatable, usually responding to treatment of the cause and to short courses of benzodiazepines (BZDs) or electroconvulsive therapy (ECT)[ 4 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

Catatonia in older adults: A systematic review

Jaimes-Albornoz¹,

Pellon-Santamaria²,

Nizama-Vía³

et al. 2022

WJP

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“…In summary, since its' inception over eight decades ago, the procedure of ECT has undergone modifications enabling it to become more acceptable to health professionals, patients and the general public (Fink, 2014; James et al., 2010). However, ECT is also still regarded as a stigmatized treatment (Ramos‐Garcia & González‐Salazar, 2013), viewed by some communities as controversial, painful and frightening (Ottosson & Fink, 2012). It is acknowledged that acceptance of ECT by the patient and family members often depends on how healthcare professionals present it as a treatment option (Sharma et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

Mental Health Nurse experiences of delivering care to severely depressed adults receiving electroconvulsive therapy

Lonergan

Timmins

Donohue

2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? ECT is a fast‐working and potentially life‐saving treatment, but it is still considered a controversial treatment choice. Due to lack of knowledge and public stigma, ECT can be an anxiety‐inducing treatment for people experiencing severe depression. The nurse's role is to alleviate this anxiety, aid recovery and minimize the risk of relapse. They manage this onerous task ideally through the therapeutic relationship, and use the skills of assessment and risk identification in order to maximize patient outcomes. What this paper adds to existing knowledge? The views of mental health nurses who provide care for adults receiving treatment of ECT for severe depressive illness are in the main positive. The knowledge of and attitude towards ECT among nurses may reflect on patients and influence treatment choice. If stigma is not addressed, then patients will not be appropriately informed regarding their treatment options. Mental health nurses need to engage in reflective practice to ensure that the dignity of the patient is maintained throughout this treatment. What are the implications for practice? Mental Health nurses should engage with additional training, formalized clinical supervision and avail of peer support in order to improve confidence, skills and quality of care in the delivery of ECT. Education modules should include a presentation of evidence of effectiveness of ECT as a treatment option. Dialogue among mental healthcare colleagues is important about caring for people presenting for ECT treatment. This will ensure that the mental health nurse can remain cognizant of the potential for patient distress throughout this treatment. Abstract BackgroundThere is a considerable dearth of literature on attitudes towards Electroconvulsive Therapy (ECT) as a treatment for severe depression. Despite being a highly effective treatment, it is still stigmatized even among professionals. Understanding perceptions and knowledge related to ECT treatment among healthcare providers is important for ensuring that treatment can be safely explored as a treatment option with patients. AimThe overall aim of this study is to explore the views of mental health nurses who provide nursing care to people receiving ECT for severe depressive illness in a mental health setting. MethodsThis is a qualitative study using focus groups (n = 2) with 14 mental health nurses who had a minimum of 3 months experience caring for older adults receiving ECT. Transcripts were subjected to a thematic analysis. Full ethical approval was granted for this study. ResultsIn total, four themes were identified exploring attitudinal changes, managing patient dignity, reflecting changes in practice and managing the unknown. In general, participants experienced ECT as a positive treatment option for adults with severe depressive illness contributing to an enhanced quality of life. ConclusionFindings indicate a desire to improve person‐centred care for patients undergoing ECT. Educational support for nurs...

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