The aim of this study was to report the efficacy and safety of electroconvulsive therapy (ECT) in manic, depressed, psychotic, and catatonic adolescent patients.
Medical records of 78 adolescents who ...had received ECT in Department of Psychiatry, Gaziantep University Medical Faculty, during 2011 to 2017 were reviewed. Sixty-two subjects in this sample were identified to have complete records and met the study inclusion criteria.
The mean ± SD age of subjects was 17.11 ± 1.04 years and female sex was 53.2% (n = 33). Primary the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnoses were bipolar mood disorders (n = 33, 53.2%), major depressive disorder (n = 16, 25.8%), schizophrenia (n = 8, 12.9%), and schizoaffective disorders (n = 5, 8.1%). Electroconvulsive therapy was significantly effective in treating manic, depressive, psychotic, and catatonia symptoms as evidenced by significant differences in pretreatment and posttreatment scores in outcome measures including Hamilton Depression Rating Scale, Young Mania Rating Scale, Positive and Negative Syndrome Scale, and Clinical Global Impression-Severity Scale (P < 0.001). Presence of comorbidity adversely affected treatment response (P = 0.001). However, ECT was also effective in those with comorbid diagnoses (P < 0.001). Depressive symptoms in patients with bipolar depression responded better than those with unipolar depression (P = 0.012). Electroconvulsive therapy was generally safe with subjective memory complaints (85%), headache (69%), and prolonged seizure (8%) as the reported adverse effects possibly related to ECT. Four subjects (6%) developed a manic switch during ECT.
Electroconvulsive therapy is an effective and a safe treatment option in adolescent patients with severe and resistant psychopathology. Although comorbidity may decrease treatment response, ECT seems to be effective even in the presence of multiple psychiatric diagnoses.
Few studies have investigated the relationship between electroconvulsive therapy (ECT) and markers of nitrosative stress and oxidative DNA damage.
The aim of this study is to examine changes in ...nitrosative stress and oxidative DNA damage in patients with a depressive episode treated with ECT.
The current study included 48 patients with a depressive episode treated with ECT and 30 healthy control participants. First, the serum nitrosative stress markers of nitric oxide (NO*), nitric oxide synthase (NOS), and peroxynitrite (ONOO-) and the oxidative DNA damage marker 8-hydroxy-2′-deoxyguanosine (8-OHdG) were compared between the study and control groups. These parameters were also compared pre- and post-treatment for the study group.
NO*, NOS, and ONOO- levels were significantly higher in patients with depressive disorder (DD) than in the control group. NO* and NOS levels significantly decreased in the ECT group after treatment while 8-OHdG levels significantly increased.
The study findings suggest that ECT may have reduced nitrosative stress levels while increasing oxidative DNA damage. More research is now needed to better understand the issue.
KEY POINTS
Nitrosative stress levels can increase in patients with depressive disorder.
Electroconvulsive therapy may reduce nitrosative stress while increasıng oxidative DNA damage.
These results suggest that nitrosative stress plays an important role in the mechanism of action of electroconvulsive therapy.
OBJECTIVE Pediatric cancers may have traumatic, adverse effects on healthy siblings of children with cancer. The majority of studies on the subject have been performed in Western societies, and few ...controlled studies implementing validated surveys have been performed. The aim of this study is to investigate the quality of life, prevalence of anxiety and depression and associated factors in healthy siblings of children with cancer. METHODS Sixty children aged 8-16 years-old with siblings with cancer were included as the case group and sixty children with siblings without cancer were enrolled as the control group. The Revised Child Anxiety and Depression Scale (RCAD-S) and the Questionnaire for Quality of Life Assessment for Children and Adolescents Parent Form (Kid-KINDL) were used to evaluate anxiety/depression symptoms and quality of life respectively.RESULTS The case group consisted of 30 boys and 30 girls (12.08±2.61 years), and the control group of 31 boys and 29 girls (11.40±2.11 years). Depression/anxiety symptoms were significantly higher in the case group than in the control group (p<0.05). Quality of life total score was significantly lower in the case group than in the control group (p<0.05). Being siblings of same gender was determined to be associated with impaired quality of life (B=8.81 CI: 1.56-49.65, p=0.014) and presence of depression/anxiety (B=6.89 CI: 1.29-36.72, p=0.024). CONCLUSION Professionals should include healthy siblings of children with cancer when assessing the psychosocial effect of pediatric cancer, and should adopt a multidimensional approach in caring for healthy siblings of children with cancer.
Neuroleptic malignant syndrome is a severe complication that mainly occurs based on neuroleptic drug treatment and characterized with some autonomic symptoms, altered mental state, hyperthermia and ...muscle rigidity. Amisulpride is a unique atypical antipsychotic that selectively blocks D2 and D3 receptors presynaptically in the frontal cortex and atypical antipsychotics are rarely caused neuroleptic malignant syndrome(NMS).This study examine a 20-years old male with the diagnosis of acute psychotic disorder occurred amisulpride-induced NMS and successfully treated with Electroconvulsive Therapy (ECT). We decided to present that case because of the fact that there is only limited number of amisulpride-induced NMS cases reported in the literature.
Objective: Electroconvulsive therapy (ECT) is an effective treatment method used in many psychiatric disorders, primarily in mood and psychotic disorders. ECT is also effective and safe for geriatric ...depression. This study aimed to analyze elderly patients treated with ECT in bipolar disorder, major depressive disorder and psychotic disorder diagnostic groups. Methods: In this study, we retrospectively reviewed 58 geriatric patients over 60 years old who were treated with ECT between January 2014 and December 2017. Patients' sociodemographic data, preliminary American Society of Anesthesiologists physical status assessments (ASA) scores and Clinical Global Impression (CGI), Hamilton Depression Rating Scale (HAMD), Young Mania Rating Scale (YMRS), Positive and Negative Symptom (PANSS) Scales before and after ECT were analyzed. Results: CGI, HAMD, YMRS and PANSS scores have significantly decreased after ECT. According to preoperative anesthesia consultations of the patients, 62.1% (n=36) were assessed to be in ASA 2 risk group and 34.5% (n=20) in ASA 3 risk group. One patient in the ASA 2 risk group and four patients in ASA 3 group had to discontinue treatment due to cardiovascular instability. These patients were administered medical treatment. There were no other mortalities or severe complications. Conclusion: This data shows that there were no mortalities or severe complications in elderly patients and supports the effectiveness and safety of ECT in elderly patients with bipolar disorder, major depressive disorder and psychotic disorder. Keywords: elderly, electroconvulsive therapy, safety Amac: Elektrokonvulzif tedavi (EKT), bircok psikiyatrik bozuklukta, ozellikle duygudurum bozukluklari ve psikotik bozukluklarda kullanilan etkili bir tedavi yontemidir. EKT geriyatrik depresyonda da etkili ve guvenlidir. Bu calismada EKT ile tedavi edilen yasli hastalarin bipolar bozukluk, major depresif bozukluk ve psikotik bozukluk tani gruplarinda incelenmesi amaclandi. Yontem: Bu calismada, Ocak 2014-Aralik 2017 tarihleri arasinda EKT ile tedavi edilen 60 yas ustu 58 geriyatrik hasta geriye donuk olarak degerlendirildi. Hastalarin sosyodemografik verileri, Amerikan Anesteziyoloji Dernegi (ASA) fiziksel durum siniflandirmasi ve EKT oncesi ve sonrasi bakilan Klinik Global Izlem (KGI), Hamilton Depresyon Derecelendirme Olcegi (HAMD), Young Mani Derecelendirme Olcegi (YMRS), Pozitif ve Negatif Semptom Olcegi (PANSS) puanlari analiz edildi. Bulgular: KGI, HAMD, YMRS ve PANSS skorlarinda EKT sonrasi istatistiksel olarak anlamli azalma saptandi. Preoperatif anestezi konsultasyonlarina gore hastalarin %62.1'inin (s=36) ASA 2 risk grubunda, %34.5'inin (s=20) ASA 3 risk grubunda oldugu belirlendi. ASA 2 risk grubundaki bir hasta ve ASA 3 grubundaki dort hastada, kardiyovaskuler instabilite olmasi nedeniyle EKT'ye devam edilememis, tibbi tedavi uygulanmistir. Bunlar disinda olum veya ciddi komplikasyon saptanmamistir. Sonuc: Calismamizdan elde ettigimiz verilerde yasli hastalarda olum veya ciddi komplikasyon gozlenmemistir ve bu veriler EKT'nin bipolar bozukluk, major depresif bozukluk ve psikotik bozuklugu olan yasli hastalarda etkinligini ve guvenilirligini desteklemektedir. Anahtar sozcukler: Yaslilik, elektrokonvulzif tedavi, guvenilirlik
Objective
Postoperative anxiety symptoms are distressing for both family and child. The aim of this study was to examine the prevalence of postoperative anxiety symptoms in children.
Methods
60 ...children aged 6–12 undergoing surgery were included in the study group. The study group was assessed three times in terms of separation anxiety disorder (SAD), at the time of presentation, 1 and 3 months postoperatively. A personal information form and the SAD section of the K-SADS-PL on the basis of DSM-IV diagnostic criteria for screening SAD symptoms were used.
Results
Study group consisted of 19 girls (31.7%) and 41 boys (68.3%) (mean age 8.9 ± 2.3). Four (6.6%) of the cases at the time of presentation and 13 (21.6%) in the study group met SAD diagnostic criteria in 1 month and 21 (35.0%) in 3 months. Anxiety disorder symptoms were significantly higher in the study group at 3 months postoperatively (
p
< 0.05). There is significant correlation between both SAD symptoms and duration of hospitalization. There was also a positive correlation between duration of hospitalization and parental education and SAD symptoms.
Conclusion
Greater SAD was observed in children undergoing surgical procedures. It will be useful to physicians to consider SAD after surgery in pediatric patients especially when the level of parental education and duration of hospitalization increase. Since SAD may persist long after surgery, it may cause constant fear in personality disorders and lead to psychological problems by significantly lowering quality of life.
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