• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.259-264
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• 1997

The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T. on seizure duration. The results were follows ; 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine $0.0093mgkg^{-1}$, pentothal $2.76mgkg^{-1}$ or propofol $1.42mgkg^{-1}$. 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal (35.7 sec)(p<0.001). This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.288-294
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• 1996

Background : Most studies of the pituitary hormonal responses to electroconvulsive therapy(ECT) have used limited blood sampling schedules. Little is known about the precise sequence of neuroendocrine events immediately following en ECT application. or about the regulation of the hormonal responses. Methods : Blood was sampled at three minute intervals from eleven patients(two schizophrenics and nine affective disorder patients) undergoing ECT. Each sample was immunologically assayed for arginine vasopressin(AVP), adrenocorticotropic hormone(ACTH), prolactin(PRL), and cortisol. Baseline hormone concentrations and several measures of response were determined for each hormone. The temporal and quantitative relationships among the hormonal responses were determined. Correlations were calculated between seizure duration and secretory responses. Results : All four hormones demonstrated significant secretory responses to ECT, with AVP increasing from 1.2 to 33.3pg/ml(P<0.001), ACTH from 5.4 to 32.3fmol/ml(P<0001). PRL from 21.8 to 102.2ng/ml(P<0.005) and cortisol from 20.1 to 31.1ug/dl(P<0.001). The three pituitary hormones showed consistent time courses of secretion with onset of responses by three minutes but clearly differing peak times of 3, 6, and 12-15 minutes for AVP, ACTH, and PRL, respectively. Cortisol began to rise after 6minutes and pecked between 20-30minutes. There ware no significant correlations between seizure duration and any of the secretory response measures. Conclusions : 1) The pituitary hormone response to ECT is sequential rather than synchronous 2) The AVP response was extremely rapid and more massive than those of any other hormones. 3) The ACTH response of this study was more rapid and mare robust than thai revealed by the mast of past studies. 4) The results strongly suggest that the pituitary hormones are released as a result of the seizure rather tho, the electrical stimulus. 5) The sequential pattern of responses suggests that neuroendocine feedback-regulatory mechanisms determine the response profile.

• Korean Journal of Biological Psychiatry
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• v.15 no.2
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• pp.75-82
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• 2008

Major depressive disorder(MDD) is one of the most common diseases with serious health consequences such as increased morbidity, disability, and mortality. Electroconvulsive therapy(ECT) has been used as a treatment for mental disorder since the 1930s. A growing number of recent publications support the conclusions that ECT is an effective and safe treatment for depressed patients. Dosing strategies, frequency, safety, side effects and efficacy of ECT in MDD will be considered. ECT may be an alternative to treatment with antidepressants.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.214-217
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• 1997

Electroconvulsive therapy(ECT) is one of the most effective treatment modalities for the treatment of depression, mania, schizophrenia, or other neuropsychiatric disorders. But, reportedly ECT also can produce various forms of cardiac arrhythmia. We experienced a case of ECT-induced arrhythmia(PVC) accompanied with chest pain in a schizophrenic patient during the course of plain ECT. We conclude that there is a possible causal relationship between ECT and cardiac arrhythmia(PVC). The mechanisms of cardiac arrhythmia(PVC) due to ECT may be explained by the effects of ECT to vagal and sympathetic nervous systems. from this case report, We suggest that careful cardiac monitoring before, during, and after ECT with appropriate anesthetic preparation to a patient may enable to minimize the cardiovascular side effects of ECT in the patients with neuropsychiatric disorders.

• Korean Journal of Biological Psychiatry
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• v.18 no.3
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• pp.163-167
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• 2011

Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.

• Sleep Medicine and Psychophysiology
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• v.1 no.1
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• pp.87-98
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• 1994

Objectives: To examine a defect in inhibitory gating of auditory evoked response in schizophrenics, to compare P3 latency and amplitude in negative and positive schizophrenics, and to assess the association of P3 with family history of the psychiatric disorders, electroconvulsive therapy, and clinical features. Methods: 54 schizophrenics(male 31, female 23) and 75 controls(male 33, female 42) were tested with event-related potential paradigm designed to elicit P3 response and Frankfurter Beschwerde Fragebogen. Results: In schizophrenics, the latency of P3 was significantly more delayed and the amplitude of P3 was significantly more reduced than in the controls. Significant differences in P3 latency and amplitude between negative and positive schizophrenics were not found. And significant difference in the P3 latency and amplitude between schizophrenics with family histories of psychiatric disorder and those without family histories of psychiatric disorder was not found also. The P3 latency and amplitude was not significantly related with electroconvulsive therapy and other clinical features such as age, duration of illness, onset of inllness, number of admission, and doses of antipsychotics etc. Conclusion: These results suggested that schizophrenics had a dysfunction in the process of selective attention and that P3 was not significantly related with family history of the psychiatric disorders, positive and negative symptoms, electro1convulsive therapy, and clinical features in schizophrenics.