Comprehensive exams for Mental Health Q 74

Correct Answer: B. Depression

Electroconvulsive therapy (ECT) can provide relief for patients with severe depression who have not been able to feel better with other treatments. In some severe cases where rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention. ECT consists of a series of sessions, typically three times a week, for two to four weeks. ECT is indicated in patients with treatment-resistant depression or severe major depression that impairs activities of daily living. The definition of treatment-resistant depression is depression that is unresponsive to multiple antidepressant medication trials.

Option A: Suicidal ideation is rapidly relieved by ECT, and complete resolution was seen in 38% of patients after one week, 61% of patients after two weeks and in 81% of patients with the completion of ECT. ECT is also recommended for patients that have exhibited a favorable response to ECT previously. ECT is a relatively safe and low-risk procedure that is helpful in the treatment of depression, suicidality, severe psychosis, food refusal secondary to depression, and catatonia.

Option C: There are also suggestions for ECT as a treatment for suicidality, severe psychosis, food refusal secondary to depression, and catatonia. Bipolar depressive and manic patients can also receive treatment with ECT. ECT may have a safer profile than antidepressants or antipsychotics in debilitated, elderly, pregnant, and breastfeeding patients.

Option D: In a patient under intravenous sedation or general anesthesia, electroconvulsive therapy (ECT) uses an electric current to create a generalized cerebral seizure. Although it is primarily utilized to treat patients with severe depression, patients with schizophrenia, schizoaffective disorder, catatonia, neuroleptic malignant syndrome, and bipolar disorder may also benefit.