DEBATE IN MENTAL HEALTH NURSING

“ECT Theraphy for Schizophrenia”

Name of Group
Ihsan Nur Mahmudi (P27820714015)
Fika Agustina (P27820714023)
Fitrah Nurani Erba Putri (P27810714030)
Efrizal Fikri Harlianto (P27820714032)

D IV KEPERAWATAN GAWAT DARURAT

POLITEKNIK KESEHATAN KEMENTERIAN KESEHATAN
SURABAYA
TAHUN AKADEMIK 2015/2016
 “Mental Health Nursing”

Mental health nursing is a specialized area of nursing practice committed

to promoting mental health through the assessment, diagnosis, and treatment of
human responses to mental health problems and psychiatric disorders. Mental
health nursing, a core mental health profession, employs a purposeful use of self
as its art and a wide range of nursing, psychosocial, and neurobiological theories
and research evidence as its science. Mental health nurses provide comprehensive,
patient-centered mental health and psychiatric care and outcome evaluation in a
variety of settings across the entire continuum of care. Essential components of
this specialty practice include health and wellness promotion through
identification of mental health issues, prevention of mental health problems and
care and treatment of persons with psychiatric disorders.
Mental Health Nursing as a specialty has its roots in 19th century reform
movements to reorganize mental asylums into hospitalized settings and develop
care and treatment for the mentally ill. (Church, 1982). The first organized efforts
to develop psychiatric nursing started at McLean Asylum in Massachusetts in
1882. Early nursing leaders such as Harriet Bailey, Euphemia Jane Taylor and
Lillian Wald supported the Mental Hygiene Movement and advocated for the
acceptance of the emerging specialty of psychiatric nursing into the larger
community of general nursing. The first nurse-organized training program for
psychiatric nursing within a general nursing education program was established at
Phipps Clinic at Johns Hopkins Hospital in 1913. This served as prototype for
other nursing education programs. (Buckwalter & Church, 1979).
Under nursing leadership, psychiatric mental health nursing evolved from
the narrow focus of medical models and mind-body dichotomy towards a
biopsychosocial approach to mental illness including the concept of mind as
expressed in behavior and adaptation to experience (Church, 1982). As early as
1914, Adelaide Nutting, a well-known nursing educator at Teachers College at
Columbia, addressing a conference at the new. Psychopathic Hospital in Boston
emphasized the role that nursing could play, not only in promoting recovery from
mental illness, but in prevention of mental illness through the educative aspects of
nursing care (Nutting, 1926).
Mental health nursing leaders played a critical role in identifying and
developing relevant, specialized bodies of knowledge and securing the didactic
and clinical experiences necessary for students to develop to achieve competence
as mental health nurses. They were successful in promoting the integration of
mental health concepts into general nursing educational programs facilitating a
national public awareness of the inter-relationship of mental and physical health
in achieving patient outcomes. Through their efforts, psychiatric mental health
nursing practice moved far beyond the walls of state hospital institutions in
meeting the mental health needs of the broader community (Church, 1982). This
position and visibility became extremely important when the next wave of reform
occurred in the 1940’s with the passage of the Mental Health Act.
In the face of evolving trends and issue, mental psychiatric nursing
profession in Indonesia has taken measures such as establishing the standard of
nursing practice in the mental hospital, a professional nursing practice model in a
mental asylum, and conducted various training such as training in mental nursing
care and “clinical instructor” training for mental psychiatric nurse. However,
perhaps there are many thing need to tidy up and to improve so that able to face
all challenges in the future.
Here are mental psychiatric nursing profession should concern in the face
of trends and issue of psychiatric nursing service in the era of globalization, such
as: a) Related with the trend of global major health problems and global mental
health services, it’s the time for mental nursing service focus based on the
community (community-based care) which gives emphasis on preventive and
promotive, b) Related with the rapid improvement of science and, it is a need to
improve nursing science by developing existed educational institutions and
specializing mental nursing program. Equally important is to increase research on
mental psychiatric nursing, particularly mental nursing clinic, c) In order to
maintain quality of provided services and to protect consumers, it's time to make
“license” for nurses who work in this service, d) Due to differences between our
cultural backgrounds and the keynote speaker, which in this case we still refer to
the Western countries especially the United State, it is necessary to refine the
concepts of psychiatric mental nursing obtained from outside. Estin (1999)
emphasized that to build trust and therapeutic relationships with clients and to
prevent delays in diagnosing client needs, nurses need to understand the patients’
culture, values, beliefs, and attitudes toward their mental disorder.
In Indonesia the number of people with severe mental illness is sufficient
cause for concern, reaching 6 million people, or about 2.5% of the total
population. Based Mental Health Survey of Household (MHSH) in 1985 were
carried out against the population in 11 municipalities by the Indonesian
Psychiatric Epidemiology Network, found 185 per 1,000 adult household
population showed symptoms of mental health disorders that both light and heavy.
With another analogy that one of the five residents of Indonesia was mentally ill
and mentally. A phenomenon that is very alarming figures for a nation
(Anonymous, 2009). This certainly is not biased underestimated by this nation.
In 2006, the World Health Organization (WHO) said 26 million people in
Indonesia are mentally handicapped. Ministry of Health recognizes the estimated
2.5 million people in this country has been a mental patient (Anonymous, 2009).
Another source said that the number of people with mental disorders in Indonesia
at this time, according to data from the Ministry of Health in 2007, reaching more
than 28 million people, with a mild mental disorder category of 11.6 percent and
0.46 percent of the population suffer from severe mental disorders (Anonymous,
2010). Estimates are truly alarming and terrible. The amount of schizophrenia
patient in Indonesia also increase each years. First, We will discuss about
schizophrenia illness and then about the theraphy treatment, especially for ETC
treatment.
Schizophrenia is a mental disorder characterized by abnormal social
behavior and failure to understand reality. Common symptoms include false
beliefs, unclear or confused thinking, hearing voices, reduced social engagement
and emotional expression, and a lack of motivation. People often have additional
mental health problems such as anxiety disorders, major depressive illness or
substance use disorder. Symptoms typically come on gradually, begin in young
adulthood, and last a long time.
 The cause of schizophrenia is believed to be a combination of
environmental and genetic factors. Possible environmental factors include being
raised in a city, cannabis use, certain infections, parental age, and poor nutrition
during pregnancy. Diagnosis is based on observed behavior and the person's
reported experiences. During diagnosis a person's culture must also be taken into
account. As of 2013 there is no objective test. Schizophrenia does not imply a
"split personality" or "multiple personality disorder" — a condition with which it
is often confused in public perception.
Individuals with schizophrenia may experience hallucinations (most
reported are hearing voices), delusions (often bizarre or persecutory in nature),
and disorganized thinking and speech. The last may range from loss of train of
thought, to sentences only loosely connected in meaning, to speech that is not
understandable known as word salad. Social withdrawal, sloppiness of dress and
hygiene, and loss of motivation and judgment are all common in schizophrenia.
There is often an observable pattern of emotional difficulty, for example lack of
responsiveness. Impairment in social cognition is associated with schizophrenia,
as are symptoms of paranoia. Social isolation commonly occurs. Difficulties in
working and long-term memory, attention, executive functioning, and speed of
processing also commonly occur. In one uncommon subtype, the person may be
largely mute, remain motionless in bizarre postures, or exhibit purposeless
agitation, all signs of catatonia. About 30 to 50 percent of people with
schizophrenia fail to accept that they have an illness or comply with their
recommended treatment. Treatment may have some effect on insight. People with
schizophrenia often find facial emotion perception to be difficult. People with
schizophrenia may have a high rate of irritable bowel syndrome but they often do
not mention it unless specifically asked.
Schizophrenia is often described in terms of positive and negative (or
deficit) symptoms. Positive symptoms are those that most individuals do not
normally experience but are present in people with schizophrenia. They can
include delusions, disordered thoughts and speech, and tactile, auditory, visual,
olfactory and gustatory hallucinations, typically regarded as manifestations of
psychosis. Hallucinations are also typically related to the content of the delusional
theme. Positive symptoms generally respond well to medication. Negative
symptoms are deficits of normal emotional responses or of other thought
processes, and are less responsive to medication. They commonly include flat
expressions or little emotion, poverty of speech, inability to experience pleasure,
lack of desire to form relationships, and lack of motivation. Negative symptoms
appear to contribute more to poor quality of life, functional ability, and the burden
on others than do positive symptoms. People with greater negative symptoms
often have a history of poor adjustment before the onset of illness, and response to
medication is often limited.
The first-line psychiatric treatment for schizophrenia is antipsychotic
medication, which can reduce the positive symptoms of psychosis in about 7 to 14
days. Antipsychotics, however, fail to significantly improve the negative
symptoms and cognitive dysfunction. In those on antipsychotics, continued use
decreases the risk of relapse. There is little evidence regarding effects from their
use beyond two or three years.
The choice of which antipsychotic to use is based on benefits, risks, and
costs. It is debatable whether, as a class, typical or atypical antipsychotics are
better. Amisulpride, olanzapine, risperidone and clozapine may be more effective
but are associated with greater side effects. Typical antipsychotics have equal
drop-out and symptom relapse rates to atypicals when used at low to moderate
dosages. There is a good response in 40–50%, a partial response in 30–40%, and
treatment resistance (failure of symptoms to respond satisfactorily after six weeks
to two or three different antipsychotics) in 20% of people. Clozapine is an
effective treatment for those who respond poorly to other drugs ("treatment-
resistant" or "refractory" schizophrenia), but it has the potentially serious side
effect of agranulocytosis (lowered white blood cell count) in less than 4% of
people.
Most people on antipsychotics have side effects. People on typical
antipsychotics tend to have a higher rate of extrapyramidal side effects while
some atypicals are associated with considerable weight gain, diabetes and risk of
metabolic syndrome; this is most pronounced with olanzapine, while risperidone
and quetiapine are also associated with weight gain. Risperidone has a similar rate
of extrapyramidal symptoms to haloperidol. It remains unclear whether the newer
antipsychotics reduce the chances of developing neuroleptic malignant syndrome
or tardive dyskinesia, a rare but serious neurological disorder.
For people who are unwilling or unable to take medication regularly, long-
acting depot preparations of antipsychotics may be used to achieve control. They
reduce the risk of relapse to a greater degree than oral medications. When used in
combination with psychosocial interventions they may improve long-term
adherence to treatment.The American Psychiatric Association suggests
considering stopping antipsychotics in some people if there are no symptoms for
more than a year.
Schizophrenia affects around 0.3–0.7% of people at some point in their
life, or 24 million people worldwide as of 2011. It occurs 1.4 times more
frequently in males than females and typically appears earlier in men—the peak
ages of onset are 25 years for males and 27 years for females. Onset in childhood
is much rarer, as is onset in middle or old age.
Despite the prior belief that schizophrenia occurs at similar rates
worldwide, its frequency varies across the world, within countries, and at the local
and neighborhood level. This variation has been estimated to be fivefold. It causes
approximately one percent of worldwide disability adjusted life years and resulted
in 20,000 deaths in 2010. The rate of schizophrenia varies up to threefold
depending on how it is defined.
In 2000, the World Health Organization found the percentage of people
affected and the number of new cases that develop each year is roughly similar
around the world, with age-standardized prevalence per 100,000 ranging from 343
in Africa to 544 in Japan and Oceania for men, and from 378 in Africa to 527 in
Southeastern Europe for women. About 1.1% of adults have schizophrenia in the
United States. Mental disorder or Schizophrenia can be categorized in the
multicausal disease. Therefore, many concept models that attempt to explain the
phenomenon of mental disorders. Therapeutic approaches also varied. All these
therapies are called Modality Treatment. In the modality treatment there is various
types of therapy, such as :
 Individual therapy
  Environment therapy
 Biological therapy
 Cognitive therapy
 Family therapy
 Group therapy
 Behavioral therapy
 Playing therapy
We will talk about the biologic theraphy. Based on the medical model are
view mental illness as a disease. Abnormal behavior as a result of disease or as a
result of certain organisms and certain biochemical. Biologic theraphy are consists
of psychoactive medications, nutritional itervensi, ECT. Our group will take the
topic about the ETC, because we are think that the ETC theraphy is still more
controversial to be done to the patient as the theraphy. But for some cases there
are no more choice to be done.
If medication and therapy aren’t helping your depression or severe manic
episodes are destroying your life or that of a loved one. Despite treatment, then
you need to find a better treatment option. For some people, the answer for severe
mood symptoms is electroconvulsive therapy. Typically referred to as ECT for
short, electroconvulsive therapy (or “shock therapy”) is a medical procedure that
sends currents of electricity through your brain.
In 1937, an Italian neurologist named Ugo Cerletti was convinced that
metrazol-induced convulsions were useful for the treatment of schizophrenia, but
far too dangerous and uncontrollable to be applied (there was no antidote to stop
the convulsions at the time, as it happened with insulin). Furthermore, they were
highly feared by the patients. Cerletti knew that an electric shock across the head
produced convulsions, because as an specialist in epilepsy, he had done
experiments with animals on the neuropathological consequences of repeated
epilepsy attacks. In Genoa, and later in Rome, he used a electroshock apparatus to
provoke repeatable, reliable epileptic fits in dogs and other animals. The idea to
use ECT in humans came first to him by watching pigs being anesthetised with
electroshock before being butchered, as a kind of anesthesia, and so he convinced
two colleagues, Lucio Bini and L.B. Kalinowski (a young German physician) to
help him in developing a method and an apparatus to deliver brief electric shocks
to human beings.
They first experimented with several kinds of devices and animals, until
determining the ideal parameters and perfecting the technique, and then followed
up with a series of electroshocks in human subjects (with acute-onset
schizophrenia). After 10 to 20 ECT shocks in alternate days, the improvements in
most of the patients were startling. One of the unexpected benefits of transcranial
electroshock was that it provoked retrograde amnesia, or a loss of all memory of
events immediately anterior to the shock, including its perception. Therefore, the
patients had no negative feelings towards the therapy, as it happened with
metrazol shock. Furthermore, ECT was more reliable and controllable and less
dangerous to the patient than metrazol.
In 1939, Kalinowski began a tour to advertise ECT around the globe,
visiting the Netherlands, France, Switzerland, England, and the United States.
Researchers who adopted Cerletti-Bini's method soon discovered that it seemed to
have spectacular effects on affective disorders. According to E.A. Bennett. 90 %
of cases of severe depression which were resistant to all treatments disappeared
after three or four weeks of ECT. Soon, curare and scopolamine were being used
in conjunction with ECT, and gradually it replaced metrazol and insulin-induced
shock. ECT was to begin its long journey as the shock therapy of choice in the
majority of hospitals and asylums around the world. Other kinds of physical shock
therapy were briefly tested, such as the induction of fever by means of
radiomagnetic microwaves, transient brain anoxia induced by breathing a mixture
of oxygen and nitrogen and lowering the body's temperature. Results were mixed,
and they were all abandoned in favor of ECT, cheaper and more reliable.
Significant improvements in the technique of ECT have been made since
then, including the use of synthetic muscle relaxants, such as succinylcholine, the
anesthesia of patients with short-acting agents, pre-oxygenation of the brain, the
use of EEG seizure monitoring and better devices and shock waveforms. Despite
these advances, the popularity of ECT greatly decreased in the 1960s and 1970s,
due to the use of more effective neuroleptics and as a result of a strong anti-ECT
movement, as we will see below. However, ECT gained evidence again in the last
15 years, due to its efficacy. It is the only somatic therapy from the 30's that
remains in widespread use today. Between 100,000 and 150,000 patients are
subjected to ECT every year in the USA, under strictly defined medical
conditions.
Preparation before procedure of ECT :
a) Implementation, ECT can only be done on the advice of a doctor psychiatrist.
A doctor who attended the implementation of the ECT should be a doctor or a
psychiatrist consultant psychiatrist who has completed a course of ECT and
experienced in managing ECT. Doctors who perform actions ECT
psychiatrist is a physician who has received formal training in the use of
ECT, in accordance with the criteria of each institution (ECT Manual Gov.
Victoria, 2009).
b) Examination of the status of psychiatry, psychiatrist physician determines that
a patient has a qualifying condition for ECT based on the evaluation of the
status of medical and psychiatric status (Ghaziuddin, 2004).
c) Communication and provision of information, provided in writing
accompanied by a fairly frequent meetings between patients, families and
physicians for consultation is very important because some terminally ill
patients may have difficulty remembering the pre-ECT consultation. It is
suggested that an information sheet includes the nature of the treatment, the
procedure and the expected benefits and possible risks. (ECT Manual Gov.
Victoria, 2009).
d) Approval of treatment. A consent form is given in writing, signed and must
be obtained from the patient and family at each ECT treatment (ECT Guide,
2006).
e) Cognitive assessment. Based on cognitive function is recommended using the
Mini Mental State Examination (MMSE) (ECT Guide, 2006).
f) Simultaneous treatment, it is generally better to reduce or discontinue the
drug as much as possible to reduce the risk of delirium and cognitive
minimize side effects. Drugs - drugs that will interfere with seizures
(anticonvulsants and benzodiazepines) should be minimized, and drugs that
 optimize the patient's medical condition should be given before the TEK
(Kellner, 2012)
But, until now there are no definitive results from ECT therapy and too
many negative impacts of that therapy. Even, there some asylum that do abuse to
the patient with that ECT therapy to controled them. We have found some jurnal
that were talked about that. As it happened with psychosurgery, electroconvulsive
therapy was a highly troublesome therapy. First, there were many examples of
ECT being used to subdue and to control patients in psychiatric hospitals.
Troublesome patients received several shocks a day, many times without proper
restraint or sedation. Medical Historian David J. Rothman affirmed in
an NIH Consensus Conference on ECT in 1985:
"ECT stands practically alone among the medical/surgical interventions in that
misuse was not the goal of curing but of controlling the patients for the benefits of
the hospital staff"
However, in the 70's, strong movements against institutionalized
psychiatry began in Europe and particularly in the USA. Together with
psychosurgery, ECT was denounced by libertarians, and the most famous libel
was a 1962 novel written by Ken Casey, based on his experiences on an Oregon
mental hospital. Titled "One Flew Over the Cuckoo's Nest", it was later made into
a highly successful movie by Czech director Milos Forman, starring Jack
Nicholson. Bad press turned into a series of legal actions involving the abuses of
shock therapy. By the mid-1970s ECT had fallen into disrepute. Psychiatrists
increasingly made use of powerful new drugs, such as thorazine and other
antidepressives and antipsychotics.
ECT does have its dark side. ECT can cause adverse mental side effects.
Some patients, especially seniors, experience a period of confusion immediately
following ECT treatment. The confusion often lasts from a few minutes to a few
hours, although in rare cases it can linger for several days. This side effect may
make it impossible for you to return to work or other responsibilities right after
treatment.
Another mental side effect of ECT is memory loss, which can take several
forms. For instance, some have trouble remembering events that happened in the
days or weeks prior to treatment. Other people will have trouble recalling things
that happened after the treatment ended. This can be a significant side effect, as it
has the potential to impact the things you do every day, like caring for your
children or performing well at work. Studies suggest, however, that problems with
memory loss typically improve within a few months.
ECT can have physical side effects. Some report headaches and muscle
pain, while others report nausea. For most people, the physical side effects of
electroconvulsive therapy disappear within an hour or so and last for a far shorter
period than side effects from conventional medications.
ECT can have medical complications. Like other medical procedures, ECT
does carry the risk of complications, and those risks increase when anesthesia is
used. For instance, since ECT can elevate your heart rate and blood pressure, it
might be a riskier procedure if you have any kind of heart condition. Always talk
to your primary care doctor before choosing electroconvulsive therapy to find out
if you’re at risk for health complications.
ECT is expensive. This type of therapy does come at a price. The
treatment is often prescribed in a series of 6 to 12 sessions, and insurance
companies may not cover the entire cost. Before getting ECT, always check with
your insurance provider to confirm if they’ll pay for all or part of the therapy.
While it can be expensive, keep in mind that it is likely less costly than living with
an untreated or under-treated medical condition. If your mental illness is severe, it
can be hard to keep a job or take care of yourself.
The benefits of ECT aren’t permanent. Although it can be very effective in
the short-term, ECT is not a permanent solution. You may need to undergo
regular treatment to keep symptoms at bay. Your treatment provider may also
recommend that you continue other forms of treatment, like medication or talk
therapy, to reduce the risk of relapse. Due to the risk of side effects like memory
loss, ECT is considered a high-risk treatment by some medical and mental health
professionals.
Paulo Coelho, a world-famous Brazilian writer, had also been undergoing
ECT. ECT therapy was finally banned in Brazil after Coelho unravel this vicious
practice in one of his novels. Likewise, there are medical reasons other than a
psychiatrist Indonesia, Willy F. Maramis, in his book "Notes of Medical Sciences
Life". Willy, this famous psychiatrist wrote that the point that the real efficacy of
ECT in schizophrenia healing is still in doubt, and even debated. In his book, he
wrote, "What is actually (Electro Therapy Convulsions / ECT) can cure patients
with psychiatric disorders is not known with certainty. Various theories have been
put forward, there is an organic-oriented and there is also a psychological-
oriented, but until now there has been no agreement on how it works "(Maramis,
2005: 475). He wrote that ECT is a practice since many years ago, but the medical
proof for the success cases are still unknown.

We also have the data from Schizophrenia patient, he definetly refuse the
ECT theraphy program. He said “No for ETC”, he want to the doctor or nurse
who do ETC to the Schizophrenia pasient just “Humanizing the human” and not
doing that theraphy procedure.
As for the side effects that occurred after patients in ECT / electric shock
are:
- Bleeding brain
- Apneu
- Cirrhosis light
- Hypoxia
- Cephalgia
Which is always the case:
- Lips / tongue biting
- Dental rocking
- Fractures:
- Spine
- Bones flat (Illeum & Scapula)
- Luksasio Mandibulae
- Pneumonia
- CVA / stroke
- Apneu too long
ECT treatment when questioned after ECT, patients can still experience
recurrence. Meanwhile, if you trace the historical roots in the treatment of
schizophrenia, ECT / electric shock therapy have also started their treatment other
extreme (of patients with schizophrenia, such as therapeutic insulin coma, cold
therapy, the practice of dropping patients skizo into the barn contains a snake that
had filmed under the title "The Snake Pit" (1948), etc.
Even so, due to the risk of side effects like memory loss, ECT is
considered a high-risk treatment by some medical and mental health
professionals. However, the benefits can outweigh the risks for people living with
debilitating, treatment-resistant disorders. If you suffer from depression that’s so
severe you can’t get out of bed to make breakfast or if you have serious manic
episodes that make it impossible to hold down a job, then ECT may be an option
worth considering.
ECT is much safer than in years past. Perhaps you’ve seen the movie,
“One Flew Over the Cuckoo’s Nest”, and remember the disturbing scene in which
Jack Nicholson’s is given ECT. Fortunately, ECT today has little resemblance to
that depiction.
In the early years of ECT, the electrical currents were delivered in more
powerful doses. It was also often administered without anesthesia. The result was
a therapy that was painful and had serious side effects, including broken bones.
ECT is a much safer treatment now because it uses lower levels of electrical
currents. The use of muscle relaxants and anesthesia has also reduced the severe
spasms that generated injuries in the past.
ECT brings about fast results. The change in brain chemistry due to ECT
is essentially instant. This results in the immediate relief of symptoms of some
mental illnesses. The electrical current lasts for only a few seconds and the seizure
lasts for up to a minute; in fact, you can expect to spend most of treatment time in
preparation and recovery. Typically, patients begin to see significant improvement
after just 2 or 3 treatments. Since medications sometimes take weeks to be
effective, electroconvulsive therapy may be an ideal option if you’re struggling
with suicidal thoughts or experiencing a debilitating manic episode.
ECT often works when other treatments have failed. There are times when
talk therapy and medication simply aren’t working – or aren’t working quickly
enough. Medical professionals may use electroconvulsive therapy for hard-to-treat
cases of several psychiatric disorders, including:
• Depression
• Schizophrenia
• Severe mania
• Catatonia
• Tourette syndrome
• Obsessive compulsive disorder
ECT works for those who can’t or won’t take medication. If you can’t
tolerate your medication’s side effects or have episodes (e.g. psychotic or manic)
in which you refuse to take prescription drugs (e.g. due to paranoia), ECT may
help. Instead of taking medications every day or every few hours, you’ll visit a
medical facility several times a week. Since general anesthesia is often used,
you’ll also need to arrange transportation to and from treatment. That means at
least one additional person will be around to make sure you get the help you need.
Dr, Soroya Bacchus, a psychiatrist practicing in California, says ECT is a
very successful treatment and works when other treatment
fails. “Electroconvulsive therapy (ECT) is the most effective treatment option we
have available, bar none,” she says. “It is literally like rebooting the brain.”
It was true that ECT can be fatal, but deaths are extremely rare. About 1 in
10,000 people die from ECT. This is lower than the U.S. suicide rate, which is
estimated to be 12 in 100,000 people.
Of some previous studies the use of ECT many side effects. But recently,
researchers from Columbia University designed a new ECT procedure is claimed
to reduce side effects. If the conventional ECT electric current is applied for 1.5
milliseconds, then at the latest procedure is shortened to 0.3 milliseconds.
According to a review by the U.S. Food and Drug Administration, 78
percent of patients with clinical depression improved after ECT. In addition,
people who are treated with ECT have a 70 to 90 percent remission rate. This
compares to a 20 to 30 percent rate for those taking medications. The reason ECT
is so effective remains unclear. Some researchers believe it helps to correct an
imbalance in the brain’s chemical messenger system. Another theory is that the
seizure somehow resets the brain.
ECT works for many people when drugs or psychotherapy are ineffective.
There are typically fewer side effects than with medications. ECT works quickly
to relieve psychiatric symptoms. Depression or mania may resolve after only one
or two treatments. Many medications require weeks to take effect. Therefore, ECT
can be especially beneficial for those who are suicidal, psychotic, or catatonic.
However, some people may require maintenance ECT (or medications) to
maintain the benefits of ECT. Your doctor will need to monitor your progress
closely to determine the best follow-up care for you. ECT may be safely used on
both pregnant women and those with heart conditions.
From some of the journals we have read, we can conclude that in mental
disease there are various types of psychological disorders. But the cause is still
not known with certainty. One of them in the case of is Schizophrenia. The
treatment itself can through psychotic drugs and ECT. Which is still debated to
this day is the ECT therapy itself. ECT therapy is a therapy that is done by an
electric discharge into the human body through electrodes attached to the head
directly with a specific electric charge. But the use of ECT too many negative
effects to the patient and the results of the treatment are also unclear. Even it can
impact on a patient's death. The researchers are now claim that the use of ECT is
much safer. Recently, researchers from Columbia University designed a new ECT
procedure is claimed to reduce side effects. If the conventional ECT electric
current is applied for 1.5 milliseconds, then at the latest procedure is shortened to
0.3 milliseconds.
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Dawkins, Karon, 2012, ‘Refinements in ECT Techniques’, Psychiatric Times,
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