Gülçin ELBOĞA, Elif KARAYAĞMURLU, Şengül KOCAMER ŞAHİN, Abdurrahman ALTINDAĞ

Analysis of elderly patients treated with electroconvulsive therapy and complication rates: a single center experience

Objective: Electroconvulsive therapy (ECT) is an effective treatment method used in many psychiatric disorders, primarily in mood and psychotic disorders. ECT is also effective and safe for geriatric depression. This study aimed to analyze elderly patients treated with ECT in bipolar disorder, major depressive disorder and psychotic disorder diagnostic groups. Methods: In this study, we retrospectively reviewed 58 geriatric patients over 60 years old who were treated with ECT between January 2014 and December 2017. Patients’ sociodemographic data, preliminary American Society of Anesthesiologists physical status assessments (ASA) scores and Clinical Global Impression (CGI), Hamilton Depression Rating Scale (HAMD), Young Mania Rating Scale (YMRS), Positive and Negative Symptom (PANSS) Scales before and after ECT were analyzed. Results: CGI, HAMD, YMRS and PANSS scores have significantly decreased after ECT. According to preoperative anesthesia consultations of the patients, 62.1% (n=36) were assessed to be in ASA 2 risk group and 34.5% (n=20) in ASA 3 risk group. One patient in the ASA 2 risk group and four patients in ASA 3 group had to discontinue treatment due to cardiovascular instability. These patients were administered medical treatment. There were no other mortalities or severe complications. Conclusion: This data shows that there were no mortalities or severe complications in elderly patients and supports the effectiveness and safety of ECT in elderly patients with bipolar disorder, major depressive disorder and psychotic disorder. (Anatolian Journal of Psychiatry 2019; 20(6):613-618)

Elektrokonvülzif tedavi uygulanan yaşlı hastalar ve komplikasyon oranları: Bir merkez deneyimi

Amaç: Elektrokonvülzif tedavi (EKT), birçok psikiyatrik bozuklukta, özellikle duygudurum bozuklukları ve psikotik bozukluklarda kullanılan etkili bir tedavi yöntemidir. EKT geriyatrik depresyonda da etkili ve güvenlidir. Bu çalışmada EKT ile tedavi edilen yaşlı hastaların bipolar bozukluk, majör depresif bozukluk ve psikotik bozukluk tanı gruplarında incelenmesi amaçlandı. Yöntem: Bu çalışmada, Ocak 2014-Aralık 2017 tarihleri arasında EKT ile tedavi edilen 60 yaş üstü 58 geriyatrik hasta geriye dönük olarak değerlendirildi. Hastaların sosyodemografik verileri, Amerikan Anesteziyoloji Derneği (ASA) fiziksel durum sınıflandırması ve EKT öncesi ve sonrası bakılan Klinik Global İzlem (KGİ), Hamilton Depresyon Derecelendirme Ölçeği (HAMD), Young Mani Derecelendirme Ölçeği (YMRS), Pozitif ve Negatif Semptom Ölçeği (PANSS) puanları analiz edildi. Bulgular: KGİ, HAMD, YMRS ve PANSS skorlarında EKT sonrası istatistiksel olarak anlamlı azalma saptandı. Preoperatif anestezi konsültasyonlarına göre hastaların %62.1'inin (s=36) ASA 2 risk grubunda, %34.5'inin (s=20) ASA 3 risk grubunda olduğu belirlendi. ASA 2 risk gru- bundaki bir hasta ve ASA 3 grubundaki dört hastada, kardiyovasküler instabilite olması nedeniyle EKT’ye devam edilememiş, tıbbi tedavi uygulanmıştır. Bunlar dışında ölüm veya ciddi komplikasyon saptanmamıştır. Sonuç: Çalışmamızdan elde ettiğimiz verilerde yaşlı hastalarda ölüm veya ciddi komplikasyon gözlenmemiştir ve bu veriler EKT'nin bipolar bozukluk, majör depresif bozukluk ve psikotik bozukluğu olan yaşlı hastalarda etkinliğini ve güveni- lirliğini desteklemektedir. (Anatolian Journal of Psychiatry 2019; 20(6):613-618)

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