SUMMARY
Recent recommendations for the routine use of modified ECT prompted an audit to be undertaken to determine the incidence of musculoskeletal complications occurring in patients who received ECT at our centre from 1980 to 1990. Of the 13,597 treatments given, 98% were unmodified, due to the lack of availability of anesthetists. Musculoskeletal complications occurred in less than 1% of treatments and were of little clinical significance. However, modified ECT was associated with significantly greater frequency of potentially fatal complications such as cardiac arrest. The findings of this audit indicate that unmodified ECT administered by a trained team does not result in significant musculoskeletal morbidity and may be preferable to modified ECT in the absence of trained anaesthetic personnel. The decision to routinely recommend modified ECT in developing countries should await scientific debate with due consideration of the complications, resources, ethics, practicality and cost as well as the consequences of such a recommendation on clinical practice.
Full Text
The Full Text of this article is available as a PDF (200.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abramczuk J. A., Rose N. M. Pre-anaesthetic assessment and the prevention of post-ECT morbidity. Br J Psychiatry. 1979 Jun;134:582–587. doi: 10.1192/bjp.134.6.582. [DOI] [PubMed] [Google Scholar]
- American Psychiatric Association. Task Force on Electroconvulsive Therapy The Practice of ECT: Recommendations for Treatment, Training and Privileging. Convuls Ther. 1990 Jun;6(2):85–120. [PubMed] [Google Scholar]
- Fink M. Impact of the antipsychiatry movement on the revival of electroconvulsive therapy in the United States. Psychiatr Clin North Am. 1991 Dec;14(4):793–801. [PubMed] [Google Scholar]
- Heshe J., Roeder E. Electroconvulsive therapy in Denmark. Br J Psychiatry. 1976 Mar;128:241–245. doi: 10.1192/bjp.128.3.241. [DOI] [PubMed] [Google Scholar]
- Pearlman T., Loper M., Tillery L. Should psychiatrists administer anesthesia for ECT? Am J Psychiatry. 1990 Nov;147(11):1553–1556. doi: 10.1176/ajp.147.11.1553. [DOI] [PubMed] [Google Scholar]
- Shukla G. D. Electroconvulsive therapy in a rural teaching general hospital in India. Br J Psychiatry. 1981 Dec;139:569–571. doi: 10.1192/bjp.139.6.569. [DOI] [PubMed] [Google Scholar]