ABSTRACT
OBJECTIVES: There is little research on the practice and effectiveness of electroconvulsive therapy (ECT) in Korea. This study investigated the practice pattern, effectiveness, and safety of ECT. METHODS: This chart review study included electronic medical records of 180 patients treated with ECT between January 2007 and December 2013 at the Asan Medical Center. Symptomatic improvement was assessed using Clinical Global Impression (CGI) scale. Treatment response was defined as CGI improvement scale score of 2 or less. Re-hospitalization was used as an indicator of recurrence. Safety was assessed by spontaneous reports from patients. RESULTS: One hundred and eighty patients underwent 1539 sessions of modified ECT. Their most frequent diagnosis was major depressive disorder (n=74, 41.1%). The most common indication for ECT was poor response to medication (n=177, 75.3%). Treatment response rate was 66.9% in acute phase group and 63.8% in the patients with poor response to medication. The recurrence rate at six months after the end of the course was 29.6%. Memory impairment or amnesia was the most common adverse effect. CONCLUSION: There was a remarkable improvement following ECT in patients who responded poorly to medications, and most adverse effects were tolerable and temporary. The present study suggests that ECT could be a useful treatment option.
Subject(s)
Humans , Amnesia , Depressive Disorder, Major , Diagnosis , Electroconvulsive Therapy , Electronic Health Records , Korea , Memory , RecurrenceABSTRACT
OBJECTIVES: Prince Sado was the tragic royal heir who was sealed in a rice chest and starved to death by his father, King Yeongjo. The question of whether he was a victim of party strife or his death was the result of his psychiatric disorder is still controversial. In this paper, we investigated the question of whether he had suffered from bipolar disorder by reviewing his psychiatric symptoms and family history. METHODS: We examined the available literature on Prince Sado and his family, particularly focusing on Hanjungnok (Memoirs of Lady Hyegyeong), written by Prince Sado's wife. RESULTS: Review of the literature showed that Prince Sado suffered from psychiatric symptoms, including depressed mood, anxiety, suicidal behavior, aggressive behavior, and persecutory delusion from the age of 13 to 27. Many of his symptoms match the Diagnostic and Statistical Manual of Mental Disorders' criteria for depressive and manic episodes and it is highly suspected that he had bipolar disorder. He also showed clothing phobia, which can be regarded as an obsessive compulsive symptom. Some of his relatives, King Gyeongjong and Sanggyegun, might have suffered from depressive disorder. CONCLUSION: The characteristics of his symptoms suggest that Prince Sado might have had bipolar disorder. His mental disorder might explain in part the cause of his death.
Subject(s)
Humans , Anxiety , Bipolar Disorder , Clothing , Delusions , Depressive Disorder , Fathers , Mental Disorders , Phobic Disorders , Spouses , ThoraxABSTRACT
OBJECTIVES: Prince Sado was the tragic royal heir who was sealed in a rice chest and starved to death by his father, King Yeongjo. The question of whether he was a victim of party strife or his death was the result of his psychiatric disorder is still controversial. In this paper, we investigated the question of whether he had suffered from bipolar disorder by reviewing his psychiatric symptoms and family history. METHODS: We examined the available literature on Prince Sado and his family, particularly focusing on Hanjungnok (Memoirs of Lady Hyegyeong), written by Prince Sado's wife. RESULTS: Review of the literature showed that Prince Sado suffered from psychiatric symptoms, including depressed mood, anxiety, suicidal behavior, aggressive behavior, and persecutory delusion from the age of 13 to 27. Many of his symptoms match the Diagnostic and Statistical Manual of Mental Disorders' criteria for depressive and manic episodes and it is highly suspected that he had bipolar disorder. He also showed clothing phobia, which can be regarded as an obsessive compulsive symptom. Some of his relatives, King Gyeongjong and Sanggyegun, might have suffered from depressive disorder. CONCLUSION: The characteristics of his symptoms suggest that Prince Sado might have had bipolar disorder. His mental disorder might explain in part the cause of his death.