Autonomy and consent assessment for electroconvulsive therapy (ECT). A retrospective study of medical records

Investigating the factors that impede or facilitate the acceptance of electroconvulsive therapy (ECT): perspectives from psychiatrists and patients' companions

OBJECTIVES

This study aims to investigate the positive and negative factors that can influence an individual's acceptance of electroconvulsive therapy (ECT) from the perspective of psychiatrists and patients' companions (PCs).

DESIGN

A multicentre qualitative phenomenological study.

SETTING

Cities of Shiraz and Fasa in Fars province.

PARTICIPANTS

Eight psychiatrists and 10 PCs were interviewed.

METHODS AND ANALYSIS

Semistructured interviews were conducted with psychiatrists and PCs in hospitals in Fars Province, Iran. The interviews focused on the positive and negative factors influencing the participants' acceptance of ECT. Subsequently, the interviews were transcribed and subjected to thematic analysis.

RESULTS

In total, 8 males and 10 females participated. The average age of psychiatrists and PCs was 42.43±6.37 and 53.20±16.64, respectively. Furthermore, the average working experience of psychiatrists was 8.57±1.90 years. Five themes emerged from the interviews: feeling supported, awareness, communications between physicians, patients, and PCs, previous experiences of oneself and others, and hospital structure.

CONCLUSIONS

Our study provides valuable insights into the negative and positive factors that influence the acceptance of ECT from the perspectives of psychiatrists and PCs. The findings indicate important ways to enhance perspectives on ECT within the community.

Electroconvulsive therapy for catatonia in anti-NMDA receptor encephalitis: A case series

BACKGROUND

Anti-NMDAR encephalitis is the most common cause of immune-mediated catatonia.

CASE SERIES

Three females presented with neuropsychiatric symptoms and were empirically treated with first-line immunotherapy and ovarian teratoma resection for suspected autoimmune encephalitis, preceding diagnostic confirmation via NMDAR antibody positivity. They required escalating large doses of benzodiazepines for refractory malignant catatonia resulting in ICU level care. ECT treatments were initiated, and patients were gradually noted to have clinical improvement as was measured by the Bush-Francis Catatonia Rating Scale.

CONCLUSIONS

Clinicians should recognize catatonia among patients with suspected anti-NMDAR encephalitis and consider the early implementation of ECT into treatment algorithms.