Publication: Diagnostic variability and therapeutic efficacy of ECT in Nepalese sample
Date
2008
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: Though electroconvulsive therapy (ECT) has been used in Nepal for last twenty years, researches
regarding its use, its efficacy and other data are non-existent.
Aims: The objective of this study was to know about diagnostic variability and therapeutic efficacy of the use of
ECT in hospitalized patients.
Methods: This is a prospective comparative study between patients who received ECT and who did not using ICD-
10 as diagnostic confirmation. Psychopathology was evaluated using Brief Psychiatric Research Scale (BPRS),
Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS) between the groups at
admission, at discharge, at 1
Assistant Professors, Department of Anaesthesia,
Kathmandu Medical College, Sinamangal, Kathmandu, Nepal
st month, at 6th month and at 12th month. Functional assessment of patients was done
using Global Assessment of Function (GAF). Modified ECT was performed using general anaesthetic agent.
Results: 47 patients received ECT as compared to 78 patients who were non-receivers. The patients with most
common five diagnosis were paranoid schizophrenia (14.4%); psychotic depression (13.6%) ; undifferentiated
schizophrenia (8.8%) ; bipolar mania (7.2% ) ;severe depression without psychosis (5.6%) . There was significant
decrease in BPRS in ECT receiver as compared to non-receivers at discharge (p=0.0001), 1st month (p=0.0001), 6th
month (p=0.0001) and 12th month (p=0.0001) ; in YMRS at discharge (p=.008), 1st month (p=.002) and at 12th
month (p=.015) ; in HAMD-M at discharge (p=0.0001), at 1st month (p=0.0001), at 6th month (p=0.0001) and at 12th
month (p=0.0001) ; in GAF at discharge (p=0.0001), at 6th month (p=0.0001) and at 12th month (p=0.0001).
Conclusion: There was significant improvement in overall psychopathology of patients who received ECT as
compared to non-receivers. The improvement was shown by decrement in scores in BPRS, YMRS, HDRS and GAF
at the time of discharge, 1st month, 6th month and 12th month which were statistically significant. Day to day
functional status of patients also improved as shown by GAF. The efficacy of ECT was very significantly shown in
this study with all the psychiatric spectrum disorders.
Key words: ECT, YMRS, HAM-D, BPRS, GAF, Diagnostic variability.
Description
Adhikari SR¹, Pradhan SN², Sharma SC3, Shrestha BR³, Shrestha S4, Tabedar S5
¹Lecturer, ²,3Assistant Professors, Department of Psychiatry, 3,4,5 Assistant Professors, Department of Anaesthesia, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal