Bir Üniversite Hastanesi Psikiyatri Kliniğinde Elektrokonvülsif Terapi Uygulanmış Hastaların Sosyodemografik ve Klinik Özelliklerinin Retrospektif Olarak İncelenmesi

Yıl 2022, Cilt: 36 Sayı: 3, 257 - 265, 27.01.2023

İrem Tıraş , Suna Soğucak , Ali Erdoğan , Burak Kulaksızoğlu

https://doi.org/10.18614/deutip.1135618

Öz

GİRİŞ VE AMAÇ:Bu çalışmada bir üniversite hastanesi psikiyatri kliniğinde yatarak tedavi gören hastalarda elektrokonvülsif terapi (EKT) uygulamaları ile ilgili sosyodemografik ve klinik özelliklerin ortaya koyulması amaçlanmıştır
YÖNTEM VE GEREÇLER:1 Ocak 2014 – 31 Aralık 2019 yılları arasında yatarak tedavi gören 3589 hastadan EKT uygulanan 301 hasta çalışmaya dahil edilmiştir. Hastaların sosyodemografik ve klinik özellikleri retrospektif olarak değerlendirilmiştir.
BULGULAR:Kliniğimizde 6 yıllık dönemde yatarak tedavi gören 3589 hastadan 301’ine (%8,3) EKT uygulandığı saptandı. Hastaların 198’i (%65,8) kadın, 103’ü (%34,2) ise erkekti. Hastalara ortalama 8,64±2,43 seans EKT uygulandığı saptandı. Hastaların %87,7’sinin tam veya kısmi fayda gördüğü %12,3’ünün ise hiç fayda görmediği saptandı. EKT uygulamasının en sık duygudurum bozukluğu tanısı almış hastalara (%77,4), ikinci sıklıkta psikotik bozukluğu olan hastalara (%16,9) yapıldığı görüldü. Hastaların 44’ünde (%14,6) komplikasyon meydana geldiği ve bu komplikasyonların en sık konfüzyon, baş ağrısı ve unutkanlık olduğu görüldü.
TARTIŞMA VE SONUÇ:Bu çalışma EKT’nin etkili, güvenilir ve yan etki riski oldukça düşük bir tedavi olduğunu göstermiştir.

Anahtar Kelimeler

elektrokonvülsif terapi, EKT, somatik sağaltım, depresyon, duygudurum bozukluğu

Retrospective Evaluation of Sociodemographic and Clinical Characteristics of Patients Treated with Electroconvulsive Therapy in a University Hospital Psychiatry Clinic

Öz

INTRODUCTION:In this study, it was aimed to reveal the sociodemographic and clinical characteristics of electroconvulsive therapy (ECT) applications in inpatients in a university hospital psychiatry clinic.
METHODS:Among the 3589 patients who were hospitalized between January 1, 2014, and December 31, 2019, 301 patients who underwent ECT were included in the study. Sociodemographic and clinical characteristics of the patients were evaluated retrospectively.
RESULTS:It was determined that ECT was applied to 301 (8.3%) of 3589 patients who were hospitalized in our clinic during a 6-year period. Of the patients, 198 (65.8%) were female and 103 (34.2%) were male. It was determined that an average of 8.64±2.43 sessions of ECT was applied to the patients. It was determined that complete or partial remission was achieved in 87.7% of the patients, and 12.3% of them did not benefit at all. It was observed that ECT was applied most frequently to patients diagnosed with mood disorder (77.4%), and secondly to patients with psychotic disorder (16.9%). Complications occurred in 44 (14.6%) of the patients, and the most common of these complications were confusion, headache, and forgetfulness.
DISCUSSION AND CONCLUSION:This study showed that ECT is an effective, safe treatment with a very low risk of side effects.

Anahtar Kelimeler

electroconvulsive therapy, ECT, somatic therapy, depression, mood disorder

Kaynakça

• KAYNAKLAR 1 Abrams, R. Electroconvulsive therapy. Oxford University Press 2002.
• 2 Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock’s comprehensive textbook of psychiatry.10th ed. Philadelphia, PA: Lippincott Williams&Wilkins; 2017; Volume 2 Biological Therapies Pages 3280-3298.
• 3 Zeren T, Tamam L, Evlice YE. Elektrokonvülsif terapi (EKT): Bir genel değerlendirme. Arşiv Kaynak Tarama Dergisi 2003; 12(4):350-378.
• 4 Öztürk O, Uluşahin A. Ruh Sağlığı ve Bozuklukları. 15. Basım. Ankara: Nobel Tıp Kitapevleri; 2018, s.736.
• 5 Boere E, Kamperman AM, van 't Hoog AE, van den Broek WW, Birkenhäger TK. Anterograde Amnesia during Electroconvulsive Therapy: A Prospective Pilot-Study in Patients with Major Depressive Disorder. PLoS One 2016; 21;11(10):e0165392. doi: 10.1371/journal.pone.0165392.
• 6 Ingram A, Saling MM, Schweitzer I. Cognitive side effects of brief pulse electroconvulsive therapy: a review. J ECT 2008; 24(1):3-9. doi: 10.1097/YCT.0b013e31815ef24a.
• 7 Gazdag G, Ungvari GS. Electroconvulsive therapy: 80 years old and still going strong. World J Psychiatry. 2019; 4;9(1):1-6. doi: 10.5498/wjp.v9.i1.1.
• 8 Zeren T, Tamam L, Evlice YE. Elektrokonvulsifterapi: 12 yıllık uygulamanın değerlendirilmesi. Yeni Symposium 2003; 41:54-63.
• 9 Aykut D, Arslan F, Karagüzel E, Selçuk E, Uysal S, Tiryaki A. Bir üniversite hastanesi psikiyatri kliniğindeki elektrokonvulsif tedavi uygulamalarına genel bakış. Klinik Psikiyatri Dergisi 2017; 20(2):114-120. doi: 10.5505/kpd.2017.04796.
• 10 Demir EY, Taş N. Bir üniversite hastanesinde elektrokonvulsif terapi uygulaması ile ilgili özellikler. Cukurova Med J 2016; 41(2):242-247. doi: 10.17826/cutf.200108.
• 11 Ma Y, Rosenheck R, Fan N, He H. Rates and Patient Characteristics of Electroconvulsive Therapy in China and Comparisons With the United States. J ECT 2019; 35(4):251-257. doi: 10.1097/YCT.0000000000000589.
• 12 Slade EP, Jahn DR, Regenold WT, Case BG. Association of Electroconvulsive Therapy With Psychiatric Readmissions in US Hospitals. JAMA Psychiatry 2017; 74(8):798-804. doi: 10.1001/jamapsychiatry.2017.1378.
• 13 Asoğlu M, Akıl Ö, Fedai Ü, Beğinoğlu Ö, Çelik H, Kılıçaslan F. Bir Üniversite Hastanesinde Elektrokonvülsif Tedavi Uygulanan Hastaların Sosyodemografik ve Klinik Özellikleri. Akd Med J 2018; 2:123-129. doi: 10.17954/amj.2018.106.
• 14 Kuehner C. Why is depression more common among women than among men? Lancet Psychiatry 2017; 4(2):146-158. doi: 10.1016/S2215-0366(16)30263-2.
• 15 American Psychiatric Association. The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging (A Task Force Report of the American Psychiatric Association). American Psychiatric Association; 2008.
• 16 Tran DV, Meyer JP, Farber KG, Chen XR, Rosenthal BD, Kellner CH. Rapid Response to Electroconvulsive Therapy: A Case Report and Literature Review. J ECT 2017; 33(3):e20-e21. doi: 10.1097/YCT.0000000000000408.
• 17 Manohar H, Subramanian K, Menon V, Kattimani S. Does Gender Influence Electroconvulsive Therapy Sessions Required across Psychiatric Diagnoses? A 5-Year Experience from a Single Center. J Neurosci Rural Pract 2017; 8(3):427-430. doi: 10.4103/jnrp.jnrp_482_16.
• 18 Ittasakul P, Vora-Arporn S, Waleeprakhon P, Tor PC. Number of Electroconvulsive Therapy Sessions required for Thai Psychiatric Patients: a Retrospective Study. Neuropsychiatr Dis Treat 2020; 16:673-679. doi: 10.2147/NDT.S244031.
• 19 Bahji A, Hawken ER, Sepehry AA, Cabrera CA, Vazquez G. ECT beyond unipolar major depression: systematic review and meta-analysis of electroconvulsive therapy in bipolar depression. Acta Psychiatr Scand 2019; 139(3):214-226. doi: 10.1111/acps.12994.
• 20 Popiolek K, Bejerot S, Brus O, Hammar Å, Landén M, Lundberg J, Nordanskog P, Nordenskjöld A. Electroconvulsive therapy in bipolar depression - effectiveness and prognostic factors. Acta Psychiatr Scand 2019; 140(3):196-204. doi: 10.1111/acps.13075.
• 21 Bolu A, Ozselek S, Akarsu S, Alper M, Balikci A. Is there a role of gender in electroconvulsive therapy response?. Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology 2015; 25(3):228-232. doi: 10.5455/bcp.20150207075355.
• 22 Parsanoglu Z, Balaban OD, Gica S, Atay OC, Altin O. Comparison of the Clinical and Treatment Characteristics of Patients Undergoing Electroconvulsive Therapy for Catatonia Indication in the Context of Gender. Clin EEG Neurosci 2021; 18:15500594211025889. doi: 10.1177/15500594211025889.
• 23 Socci C, Medda P, Toni C, Lattanzi L, Tripodi B, Vannucchi G, Perugi G. Electroconvulsive therapy and age: Age-related clinical features and effectiveness in treatment resistant major depressive episode. J Affect Disord 2018; 227:627-632. doi: 10.1016/j.jad.2017.11.064.
• 24 Licht-Strunk E, van der Windt DA, van Marwijk HW, de Haan M, Beekman AT. The prognosis of depression in older patients in general practice and the community. A systematic review. Fam Pract 2007; 24(2):168-80. doi: 10.1093/fampra/cml071.