RESUMO
Background: Maintenance electroconvulsive therapy (M-ECT) has been in use for a long time, yet there is dearth of literature regarding stimulus characteristics and cognitive changes with M-ECT, particularly in the Indian context. To assess stimulus characteristics, clinical profile and cognitive changes in patients receiving maintenance electroconvulsive therapy. Methodology: Records of patients receiving M-ECT in one year were checked and their diagnosis, stimulus characteristics (duration of current, seizure duration, number of ECTs and total charge delivered) and serial MMSE scores (at baseline, after 1 month and final MMSE) were noted. Stimulus characteristics were correlated with sociodemographic details and cognitive changes. A comparison between psychotic and non- psychotic disorders was also made. Results: In a total of 50 patients on M-ECT, total charge delivered was found to be significantly higher in females (P=0.02) and seizure duration was longer in males (P=0.04). Stimulus characteristics between psychotic and non-psychotic disorder did not differ (P > 0.05). MMSE score showed improvement with M- ECT (P = 0.01) and this was most significant between baseline and final MMSE (P < 0.05). Cognitive change negatively correlated with number of ECT (r = - 0.29, P = 0.04). Final MMSE score correlated only with baseline MMSE score (r = 0.47, P < 0.01). Conclusion: Stimulus characteristics vary with gender, but not age and diagnosis. Cognition improves with M-ECT and depends upon number of ECT and pre-ECT cognition
RESUMO
Background: Caregiver burden and depression are related in parents of children with intellectual disability (ID), however, few Indian studies have addressed this. The Rights of Persons with Disabilities (RPwD) Act, 2016 outlines several benefits for persons with disability, but no study has looked into the knowledge parents of children with ID have about it. The present study assessed caregiver burden and the knowledge regarding RPwD Act in depressed parents of children with ID.. Methodology: The present cross – sectional, observational study recruited 50 parents of children with ID, diagnosed with Major Depressive Disorder as per DSM – 5. They were administered the Hamilton’s Depression Scale (HAM – D) and Pai and Kapur’s Family Burden Interview Schedule (FBIS) to assess for severity of depression and caregiver burden respectively. A semi-structured questionnaire was developed to assess knowledge of RPwD Act. Results: 26% of depressed parents had severe caregiver burden. Severity of depression correlated positively with caregiver’s and child’s age. Caregiver burden did not correlate with any factor. 88% of the parents were aware about the RPwD Act and certification procedure but more than 50% did not know regarding the specific provisions. Lowest knowledge was seen regarding tax rebates (4%), followed by reservations (6%). Conclusion: Caregiver burden is present in approximately one – fourth of caregivers with depression. Older children and older caregivers have more severe depression. Knowledge regarding tax rebates, educational and financial benefits in the RPwD Act appears to be poor in caregivers with depression.