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Hauge C, Rohde C, Østergaard SD. Treatment of postpartum psychotic- or mood disorder requiring admission: A nationwide study from Denmark. Acta Psychiatr Scand 2024; 150:395-403. [PMID: 37339779 DOI: 10.1111/acps.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/25/2023] [Accepted: 05/27/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Postpartum psychotic- or mood disorders are psychiatric emergencies associated with risk of suicide and infanticide. Except from case reports, there are only few descriptions of its treatment. Therefore, we aimed to describe the treatment of women admitted with postpartum psychotic- or mood disorder in Denmark with emphasis on the use of electroconvulsive therapy (ECT). METHODS We conducted a register-based cohort study of all women with incident postpartum psychotic- or mood disorder (no prior diagnoses of psychotic- or mood disorder or treatment with ECT) requiring admission in the period from 2011 to 2018. For these patients, we described the treatment and the 6-month readmission risk. RESULTS We identified 91 women with postpartum psychotic- or mood disorder with a median admission length of 27 days (interquartile range: 10-45). Of those, 19% received ECT with a median time from admission to first ECT of 10 days (interquartile range: 5-16). The median number of ECT sessions was eight (interquartile range: 7-12). In the 6 months following discharge, 90% of the women received some form of psychopharmacological treatment (62% antipsychotics, 56% antidepressants, 36% anxiolytics/sedatives, 19% lithium, and 9% mood stabilizing antiepileptics), and 31% were readmitted. CONCLUSION Psychiatric admission for incident postpartum psychotic- or mood disorder is rare in Denmark. Among those admitted, ECT and psychopharmacological treatment is commonly used. The 6-month readmission risk is high, warranting close follow-up. The fact that there is no international consensus on the optimal treatment of postpartum psychotic- or mood disorder is problematic and calls for action.
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Affiliation(s)
- Charlotte Hauge
- Regional Psychiatry Midt, Viborg, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren D Østergaard
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Grover S, Sharma P, Chakrabarti S. Use of electroconvulsive therapy during postpartum: A retrospective chart review. Indian J Psychiatry 2024; 66:572-575. [PMID: 39100373 PMCID: PMC11293785 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_165_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/28/2024] [Accepted: 05/21/2024] [Indexed: 08/06/2024] Open
Abstract
Background There is limited data on use of electroconvulsive therapy (ECT) for management of psychiatric disorders during the postpartum period from India. Aim We aimed to assess the demographic and clinical profile of patients receiving ECT during the postpartum period for various psychiatric disorders using a retrospective study design. Methods ECT register of the department was reviewed for the period of January 2019 to December 2023 to identify the patients who received ECT during the postpartum period. The treatment records of these patients were evaluated to extract the demographic and clinical profile. Results During the study period, 10 patients received ECT during the postpartum period. The mean age of the study sample was 27 (standard deviation [SD]: 2.9) years. Majority of the patients were inpatients (70%) at the time of receiving ECT. Five patients were diagnosed with first-episode depression with postpartum onset, and two patients had postpartum-onset psychotic disorder. One patient was diagnosed with recurrent depressive episode and one with bipolar disorder, current episode mania with psychotic symptom, at the time of receiving ECT. The mean number of ECTs during the ECT course was 6.7 (SD: 3.09). Nine out of the 10 patients showed good response to ECT. Conclusion Although ECT is less frequently used for management of postpartum psychiatric disorders, its use is associated with significant clinical improvement.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranshu Sharma
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Iliuta FP, Manea M, Mares AM, Varlam CI, Lacau RM, Stefanescu A, Ciobanu CA, Ciobanu AM, Manea MC. Understanding the Patient Landscape: A Ten-Year Retrospective Examination of Electroconvulsive Therapy in Romania's Largest Psychiatric Hospital. Biomedicines 2024; 12:1028. [PMID: 38790990 PMCID: PMC11117559 DOI: 10.3390/biomedicines12051028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
The aim of this analysis was to investigate the socio-demographic and clinical profile, the effectiveness, and the association of pharmacological treatment in patients who underwent electroconvulsive therapy during the last 10 years in the largest psychiatric hospital in Romania. This study includes 249 patients aged between 18 and 73 years old. Recurrent depression was the most frequent diagnosis for which ECT was performed (T = 96, 38.55%), followed by schizophrenia (T = 72, 28.91%). The most frequent indication for ECT was treatment resistance (T = 154, 61.84%), followed by persistent suicidal ideation (T = 54, 21.68%) and catatonia (T = 42, 16.86%). In 111 (44.60%) cases included in this study, re-hospitalization was required after performing ECT, while 138 (55.40%) participants did not require any further hospital readmissions. Significant differences were found between these groups in terms of socio-demographic data, diagnosis, number of ECT sessions performed, and association of psychotropic medication during and after the procedure, therefore two separate patient profiles were found based on these characteristics. Patients necessitating re-hospitalization post-ECT were mainly males aged 25-44 diagnosed with schizophrenia and underwent a greater number of ECT sessions (7-12), whereas those not requiring re-hospitalization were predominantly females aged 45-64 with recurrent depressive disorder for which 4-6 ECT sessions were performed.
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Affiliation(s)
- Floris Petru Iliuta
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
- Department of Psychiatry and Psychology, Discipline of Psychiatry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 010221 Bucharest, Romania
| | - Mirela Manea
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
- Department of Psychiatry and Psychology, Discipline of Psychiatry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 010221 Bucharest, Romania
| | - Aliss Madalina Mares
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
- Department of Psychiatry and Psychology, Discipline of Psychiatry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 010221 Bucharest, Romania
| | - Corina Ioana Varlam
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
| | - Radu Mihail Lacau
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
| | - Andreea Stefanescu
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
| | | | - Adela Magdalena Ciobanu
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
- Neurosciences Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihnea Costin Manea
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (F.P.I.)
- Department of Psychiatry and Psychology, Discipline of Psychiatry, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 010221 Bucharest, Romania
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Current Status of Electroconvulsive Therapy: Practices of a Training and Research Hospital in Ankara. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.559630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bilginer Ç, Karadeniz S. Knowledge, attitudes, and experience of child and adolescent psychiatrists in Turkey concerning pediatric electroconvulsive therapy. Asian J Psychiatr 2019; 46:74-78. [PMID: 31639553 DOI: 10.1016/j.ajp.2019.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Electroconvulsive therapy (ECT) is a treatment modality in children that can be life-saving but is rarely preferred. In this study, we aimed to evaluate the knowledge, experience, and attitudes of child and adolescent psychiatrists (CAPs) in Turkey about pediatric ECT and to draw attention to possible gaps and needs regarding this treatment in the child and adolescent psychiatric policies of Turkey. METHOD An electronic survey was prepared and shared with child and adolescent psychiatric residents and specialists. The participants were asked about their residency training, clinical experience, and opinion about ECT. The obtained data were entered in SPSS Statistics 23.0. Descriptive analyses and chi-squared tests were applied. RESULTS One hundred and ninety-one CAPs filled in the questionnaire, 28.8% of whom assessed their knowledge level as "I have no knowledge." Only 34% of them stated that their patients, most of whom had mood disorders, schizophrenia, and catatonia, had received ECT before. Four of these patients were under 12 years old. Sixty-six percent of the participants suggested that ECT was safe in adolescents, whereas only 5.8% held this view for prepubertal children. The most common reason for physicians not to apply ECT was "lack of means to apply ECT," and 92.7% stated that opportunities should be provided for pediatric ECT treatment by the hospital administration. CONCLUSION This is the first data to present the knowledge and attitudes of CAPs in Turkey about ECT. The results suggest that physicians need to have more knowledge about ECT.
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Affiliation(s)
- Çilem Bilginer
- Karadeniz Technical University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, 61080, Trabzon, Turkey.
| | - Serkan Karadeniz
- Karadeniz Technical University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, 61080, Trabzon, Turkey.
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Grover S, Sahoo S, Chakrabarti S, Basu D, Singh SM, Avasthi A. ECT in the Postpartum Period: A Retrospective Case Series from a Tertiary Health Care Center in India. Indian J Psychol Med 2018; 40:562-567. [PMID: 30533953 PMCID: PMC6241200 DOI: 10.4103/ijpsym.ijpsym_105_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the clinical profile and effectiveness of ECT in females with postpartum onset psychiatric syndromes or worsening of psychiatric disorder during the postpartum period. MATERIALS AND METHODS A retrospective chart review was carried out to identify females who had received ECT during their postpartum period from January2004 to April 2017. RESULTS During the study period, 13 females in their postpartum period received ECT, which accounted for 2.24% of the total females (n = 578) who had received ECT and 1% of total patients who were administered ECT during this period. The most common clinical diagnosis was postpartum depression (n = 7; 53.86%). Three (23.1%) patients were diagnosed with bipolar disorder and had experienced a relapse during the postpartum period. Two (15.4%) patients were diagnosed with schizophrenia and 1 (7.7%) patient was diagnosed with postpartum psychosis/acute and transient psychotic disorder. ECT was considered as a treatment of choice in 9 (69.2%) patients. All the patients with depression or mania achieved clinical remission, and patients with psychotic disorders also had significant reduction in their symptoms. Cognitive complaints were reported by 4 (30.8%) patients, and aches and pains after ECT were reported by 7 (53.8%). CONCLUSION ECT is a safe and effective treatment option in postpartum onset psychiatric syndromes or patients experiencing relapse or exacerbation of severe mental disorders during the postpartum period and is associated with a very good response rate with minimal or no complications.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debashish Basu
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shubh M Singh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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