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This is a pioneering book about the use of ECT in adolescents who are diagnosed with severe, disabling psychiatric disorders or fail conventional treatment. Included are a review of the literature, firsthand experience of the authors and case descriptions making it an invaluable guide to treatment.
The fourth edition of this popular Handbook provides the latest guidance on prescribing and administering electroconvulsive therapy (ECT). Leading researchers and practitioners review new research on ECT and related treatments, including their efficacy in children and adolescents, and in those with bipolar disorder and neurological conditions. With a focus on safe provision and minimisation of side effects, it provides the reader with practical, evidence-based advice. The book has been substantially revised: references have been updated throughout; related treatment modalities such as rTMS, tCDS and ketamine are covered in greater depth; and current administrative and legal framework guidelines are clearly outlined. An essential reference manual for consultant and trainee clinical psychiatrists, as well as ECT practitioners. This guide will benefit clinical teams looking after complex cases of depression, as well as those involved in the care of other people for whom ECT may be recommended.
Since the development of pharmacoconvulsive therapy in 1934 and of electroconvulsive therapy (ECT) in 1938, ECT has proven far more valuable than just the intervention of last resort. In comparison with psychotropic medications, we now know that ECT can act more effectively and more rapidly, with substantial clinical improvement that is often seen after only a few treatments. This is especially true for severely ill patients -- those with severe major depression with psychotic features, acute mania with psychotic features, or catatonia. For patients who are physically debilitated, elderly, or pregnant, ECT is also safer than psychotropic medications. The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in 1990 as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally. Since then, advances in the use of this technically demanding treatment prompted the APA to mandate a second edition. The updated format of this second edition presents background information followed by a summary of applicable recommendations for each chapter. This close integration of the recommendations with their justifications makes the material easy to read, understand, and use. To further enhance usability, recommendations critical to the safe, effective delivery of treatment are marked with the designation "should" to distinguish them from recommendations that are advisable but nonessential (with the designations "encouraged," "suggested," "considered"). The updated content of this second edition, which spans indication for use of ECT, patient evaluation, side effects, concurrent medications, consent procedures (with sample consent forms and patient information booklet), staffing, treatment administration, monitoring of outcome, management of patients following ECT, and documentation, as well as education, and clinical privileging. This volume reflects not only the wide expertise of its contributors, but also involved solicitation of input from a variety of other sources, including applicable medical professional organizations, individual experts in relevant fields, regulatory bodies, and major lay mental health organizations. In addition, the bibliography of this second edition is based upon an exhaustive search of the clinical ECT literature over the past decade and contains more than four times the original number of citations. Complemented by extensive annotations and useful appendixes, this remarkably comprehensive yet practical overview will prove an invaluable resource for practitioners and trainees in psychiatry and related disciplines.
Intellectual Disability (ID) describes a lifelong condition of heterogeneous aetiology, associated with the impairment of intellectual functioning (IQ
"This new edition of The ECT Handbook comes six years after the publication of the 3rd edition. In the intervening period there have been no major changes in the practice of electroconvulsive therapy, but continuing research has provided good new evidence on the optimal use of ECT in the treatment of mental disorders. This edition of the Handbook contains new chapters on ECT for bipolar depression, ECT in pregnancy and postnatally, ECT in children and adolescents and on the use of ketamine in treatment resistant depression. Many of the other chapters have been completely re-written by new authors and all have been substantially revised to include new evidence published until the end of 2018. There have been further developments to try to resolve the question about whether unilateral or bilateral ECT should be the initial technique when ECT is used in the treatment of depression and these are considered in Chapter 3. Other important new research has been conducted in the use of ECT in the treatment of bipolar depression and resistant schizophrenia and this is discussed in Chapters 5 and 10. We had expected a major revision of the guidance on the management of depression from the National Institute of Health and Care Excellence (NICE) to be published before this volume in 2018 but its publication has been delayed. There has been a significant change in mental health law in Northern Ireland, which may have implications for other legislatures, but this has not come into force at the time that the Handbook goes to print"--
This pioneering book is the first book of its kind and offers guidance about the use of ECT in youth with up-to-date and concise information. The editors, Neera Ghaziuddin MD, MRCPsych (University of Michigan, Ann Arbor, USA), and Garry Walter, MD, PhD (University of Sydney, Australia), have spearheaded the re-introduction of ECT as a safe and an effective treatment option for a subgroup of children and adolescents with severe psychiatric disorders. This book offers a review of the existing literature, firsthand experience of the authors who are regarded as experts in their respective field, and highly informative case descriptions. The book also offers a historical perspective, explaining the reasons why ECT fell out of favor, particularly among child and adolescent psychiatrists, and the resulting lost opportunity to train clinicians over many decades. Starting around the 1990's, there has been a revival of interest, probably due to the recognition of treatment resistance among some adolescents. The chapter about the mechanism of action ECT describes biological mechanisms that are known to underlie mental illness. Other chapters include a discussion about stigma associated with ECT, ethical and informed consent issues, a step-by-step guidance about using ECT, use of anesthesia during ECT and the interaction between ECT and medications. In addition, its use in youth with general medical and neurological disorders is described. The chapter detailing side effects of the treatment dispels misinformation and indicates that ECT is a safe, painless and a highly effective procedure which is not associated with any lasting side effects. The use of ECT in the treatment of specific disorders (mood and psychotic disorders, severe self-injury and catatonia) is described under respective chapters using case examples. Lay readers, families and patients considering this treatment will find the question and answer subsections at the end of each chapter useful. The experience of the editors gives a unique insight to ECT, dispelling myths and stigma and guides the reader about its proper use.
This text presents the latest clinical guidelines for psychiatrists who prescribe electroconvulsive therapy (ECT) and practitioners who administer it. It clarifies the place of ECT in contemporary practice and reviews the evidence for its efficacy.
This book comprehensively discusses the background to the passing of India's revolutionary Mental Healthcare Act, 2017, offering a detailed description of the Act itself and a rigorous analysis in the context of the CRPD and the World Health Organization (WHO) standards for mental health law. It examines the fine balance, between complying with the CRPD while still delivering practical, humane, and implementable legislation. It explores how this legislation was shaped by the WHO standards and provides insights into areas where the Indian legislators deviated from these guidelines and why. Taking India as an example, it highlights what is possible in other low- and middle-income countries. Further it covers key issues in mental health, identifying potential competing interests and exploring the difficulties and limitations of international guidelines. The book is a valuable resource for psychiatrists, nurses, social workers, non-governmental organizations and all mental healthcare workers in India and anyone studying human rights law.