Journal Article

Electroconvulsive Therapy for Depression

Lisanby, Sarah H

2007

Overview

An 82-year-old woman with severe depression, including psychotic symptoms, is referred for consideration of electroconvulsive therapy. She has had four episodes of major depression consisting of crying spells, loss of interest in usual activities, insomnia, loss of appetite and weight, difficulty with concentration, feelings of helplessness and hopelessness, and thoughts of suicide. An 82-year-old woman with severe depression, including psychotic symptoms, is referred for consideration of electroconvulsive therapy. She has had four episodes of major depression and thoughts of suicide. Foreword This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the author's clinical recommendations. Stage An 82-year-old widowed woman with a history of recurrent unipolar major depression is referred to the electroconvulsive therapy (ECT) service of an academic medical center. During her illness, she has had four episodes of major depression consisting of periods of depressed mood, crying spells, loss of interest in usual activities, insomnia, loss of appetite and weight, difficulty with concentration, feelings of helplessness and hopelessness, and thoughts of suicide. During the current episode, which has lasted for 6 months, she has had typical symptoms of melancholic depression, as well as psychotic symptoms (e.g., a somatic delusion that she has terminal . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged, 80 and over / Antidepressants / Biological and medical sciences / Depressive Disorder, Major - therapy / Electroconvulsive therapy / Electroconvulsive Therapy - adverse effects / Electroconvulsive Therapy - methods / Female / General aspects / Humans / Medical sciences / Mental depression / Mortality / Older people / Practice Guidelines as Topic / Psychology. Psychoanalysis. Psychiatry / Psychopathology. Psychiatry / Treatments