P03-371 - Electroconvulsive Therapy (ECT): a Retrospective Study of the Psychiatric unit of a Brazilian General Hospital from 1993 to 2007

Abstract

Objectives

To describe the socio-demographic and clinical characteristics, complications and therapeutic response of patients treated with ECT in the Psychiatric Unit of the General Hospital from University of Campinas-Brazil (1993-2007).

Methods

All medical records of the patients who underwent ECT were reviewed and compiled for subsequent statistical analysis by SPSS program.

Results

156 patients were studied. Ages ranged from 13 to 78 years-old, with a mean of 39.9±17.8 years-old [95% CI: 37.2-42.8 years]. There were 64 (41%) men and 92 (59%) women. The main diagnostic categories of the patients submitted to ECT were: schizophrenia (33.9%), depression without psychotic symptoms (30.8%), depression with psychotic symptoms (39.1%), bipolar disorder (18.6%) and schizoaffective disorder (3.2%). Complications occurred during the procedure in 98 cases (62.8%), immediately after the application in 85 cases (54.5%) and three days after the last session in 33 cases (21.2%).

The response to ECT was: good response in 132 (84.6%) patients, unchanged psychiatric symptoms in 14 (9%) patients and worsening in 3 (1.9%). The mean time of permanence inside the Psychiatric Unit was 57.5±38.2 days [95% CI: 51.4-63.2 days].

Table1 1: Complications during the procedure

Complications	N	%
Incomplete seizure	79	50.6%
Arrythmia	32	20.5%
Prolonged seizure	22	14.1%
Ineffective session after three applications	21	13.5%
Hypertensive episode	18	11.5%

Table 2: Complications immediately after the proce

Complications	N	%
Mental confusion	38	24.4%
Amnesia	26	16.7%
Headache	23	14.7%
Gastrointestinal alterations	18	11.5%
Pneumonia	2	1.3%
Pulmonary thromboembolism	2	1.3%
Manic turn	2	1.3%
Bronchospasm	1	0.6%
Subarachnoid hemorrhage	1	0.6%

Table 3: Complications at least three days after t

Complications	N	%
Amnesia	17	10.9%
Mental confusion	10	6.4%
Headache	6	3.8%

Conclusions

The diagnostic categories for which ECT therapy corresponded to those described in the literature. Data suggest that the incidence of complications was moderate and the response to treatment was positive in most cases, reinforcing the importance of this therapeutic method for the treatment of patients with severe mental illness.