Objective: The observation that seizures led to alleviation of the psychiatric symptoms gave way to the development of methods for inducing seizures to treat certain psychiatric diseases in early 1900s; and now it is indicated for a number of psychiatric disorders as one of the safest treatment options. In this study, we aimed to investigate retrospectively, the use of ECT with regard to indications, effectiveness, complications and clinical features of the patients underwent ECT courses between January 2012 and December 2012 in a state mental hospital.
Methods: The charts of 86 inpatients admitted in Samsun Mental Health Hospital between January 2012 and December 2012 retrospectively analyzed. Along with sociodemographic form, indication of ECT, complications during and right after the sessions, and presence of continuation treatment with ECT and comorbidity have been noted as the paramount variables of the study. All ECT sessions were conducted with anesthesia. After ECT sessions, response has been evaluated by CGI-SI and scores under three has been assumed as response. Complication has been defined as the adverse events, which occurs during or after ECT, changes course of treatment or accepted as abnormal.
Results: Between January 2012 and December 2012 only %2.2 of the inpatients underwent ECT in Samsun Mental Health Hospital. 60% of the patients who underwent ECT, has been diagnosed with a psychotic disorder such as schizophrenia, psychotic disorder-NOS or delusional disorder. This was followed by bipolar disorder-manic episode (17%). Major indication of ECT in this study was the lack of response to pharmacotherapy (30.2%). After ECT sessions, response has been observed in 73 patients (84.7%). Most of the patients (%96.5) took some medications along with ECT, mostly antipsychotics. Most of the patients were taking drug combinations, mostly antipsychotic-antipsychotic combinations. Complications such as respiratory distress, confusion, prolonged seizures has been observed in 6 patients, but mortality has not been established.
Conclusion: In this study, we observed the indications, complications and some features of ECT in a mental state hospital in Turkey. In terms of complications, ECT was safe as mentioned before in other studies. However, we found that despite its relatively high response rates and safety, ECT has not been preferred frequently by psychiatrists. The reasons of this attitude would be investigated in the future studies.