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This chapter centres the encounter between patient and psychiatrist, and between mandate Palestine and new methods of psychiatric treatment being developed around the world in the 1930s and 1940s. In particular, it focuses on three distinct methods of treatment: patient work or occupational therapy; insulin- and cardiazol-shock therapies; and electro-convulsive therapy. All in different ways sought to work (on) the body to cure the mind, and were introduced into private and government mental institutions in mandate Palestine in the decade before 1948. Though these techniques tantalised with the promise of transcending context through their universal applicability, this chapter highlights instead how these psychiatric techniques travelled to and were deployed within Palestine in a highly uneven way, and attempts to piece together some sense of how patients and their families responded to and understood these treatments as well.
Electro-convulsive Therapy (ECT) has been considered a useful for the treatment of depression and other affective disorders, however it is considered as a last resort given the risks and possible adverse effects.
Objectives
The objective of this review is to assess the use of ECT (in terms of efficacy and tolerability) for patients diagnosed with bipolar disorder and how it can be compared with other treatments more commonly used to treat this disorder.
Methods
A search was carried out in Medline and in the Virtual Health Library as well as in the Trripdatabase with the search terms “Bipolar disorder”, “Bipolar Depression”, “ECT”, “ECT treatment” and “Mania” in English and narrowing the search to the last 5 years. 8 articles were included for the review after applying inclusion and exclusion criteria.
Results
A favorable and well tolerated response was observed when applied ECT on patients with Bipolar disorder, especially the elderly populations. It was observed that the administration of unilateral and bilateral ECT are both equally effective. A better response was detected to ECT compared to newer treatments like ketamine, as well as lower suicide rate when ECT was used compared to other treatments.
Conclusions
ECT is considered an effective and safe treatment for Bipolar Disorder and should be taken into account not only as a last resort. Even so, given the limitations observed, it is necessary to carry out further investigation on the matter.
By
Vivek Kusumakar, Dalhousie University, Halifax, Nova Scotia, Canada,
Lorraine Lazier, Valley Regional Hospital, Kentville, Nova Scotia, Canada,
Frank P. MacMaster, Dalhousie University, Halifax, Nova Scotia, Canada,
Darcy Santor, Dalhousie University, Halifax, Nova Scotia, Canada
Edited by
Stan Kutcher, Dalhousie University, Nova Scotia
Bipolar disorder in adolescents and children has recently become the focus of increasing study. During adolescence, normal developmental mood shifts may complicate the diagnosis of mood disorders. The commonality of symptoms associated with a variety of childhood disorders (especially ADHD) confuses the diagnostic process. Confusion regarding comorbidity can also occur if cross-sectional rather than longitudinal analyses are conducted. Genetic imprinting is the differential gene expression depending on whether the illness is transmitted maternally or paternally. Psychosocial functioning in bipolar youth has been described premorbidly and postillness onset (4.6 years) in a cohort of BMD I teenagers. Many young people who are initially diagnosed as having unipolar depression or dysthymia later meet criteria for a bipolar disorder. Electro-convulsive therapy (ECT) in adults with bipolar illness is one of the most effective treatments in both the depressive and manic phases of bipolar illness.
Bone injury while undergoing electro-convulsive therapy is thought to be rare. We report a case of hip fracture during treatment which was associated with osteoporosis. Patients at increased risk could be identified.
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