Electroconvulsive Therapy- Other Disorders

Electroconvulsive Therapy: Other Disorders

Mental Disorders
There is a long history of ECT being used for the primary treatment of a variety of conditions other than major mood disorders and schizophrenia, including dysthymia, obsessive-compulsive disorder, eating disorders, anxiety disorders, and borderline personality disorder. In none of these disorders, however, is there compelling evidence for a true benefit, unless a major mood disorder or schizophrenia is also present (American Psychiatric Association Committee on ECT 2000). However, it is also sometimes the case that obsessive-compulsive, anxiety, hypochondriacal, and hysterical symptoms (as opposed to disorder) may occur de novo in episodes of major mood disorder or schizophrenia, and the practitioner should not be swayed against using an otherwise indicated treatment by the presence of such atypical features.

Neurological and Medical Conditions

ECT has been reported to produce improvement in affective and psychotic syndromes in patients with a variety of primary physical disorders, although the available data consist only of case reports and some retrospective series. ECT is not considered a first-choice treatment in such cases. This issue is particularly problematic with regard to patients who meet criteria for both major depression and dementia. In such cases the presence and degree of coexisting pseudodementia secondary to the mood disorder can be very difficult to evaluate, and it is best to go ahead and treat the "treatable" disorder. Specific antidelirium and anticatatonic effects have also been claimed for ECT in the context of neurological and medical conditions, although present use is primarily on a last-resort basis.

Electroconvulsive Therapy Introduction Indications