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Psychiatria Danubina, Vol. 30 No. suppl. 4, 2018.

Conference paper

ELECTROCONVULSIVE THERAPY – GENERAL CONSIDERATIONS AND EXPERIENCE IN CROATIA

Alma Mihaljević-Peleš ; School of Medicine, University of Zagreb, Zagreb, Croatia; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Maja Bajs Janović ; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Ana Stručić ; School of Medicine, University of Zagreb, Zagreb, Croatia
Marina Šagud ; School of Medicine, University of Zagreb, Zagreb, Croatia; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Milena Skočić Hanžek ; School of Medicine, University of Zagreb, Zagreb, Croatia; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Maja Živković ; Clinical Hospital Centre Zagreb, Zagreb, Croatia
Špiro Janović ; Clinical Hospital Centre Zagreb, Zagreb, Croatia

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Abstract

Despite controversy, ECT has been recognized as significantly effective for the treatment of mental disorders since 1938, when
Cerletti and Bini introduced ECT in clinical psychiatric practice for treatment of schizophrenia. In the next period, indication for
ECT switched more toward depression and catatonia. ECT was even banned from psychiatric training in 1960’s, due to the antipsychiatric
movement, which were fortified by Oscar winning movie “One Flew over the Cuckoo's Nest”. Due to its robust
effectiveness, ECT revived in the early 1980’s and today holds its position in clinical psychiatric practices around the world.
Mechanism of ECT on brain and psychopathology is still not fully understood. Main theories have been neurotransmitter, postreceptor,
neurophysiological and neuroendocrine theory. Regarding best clinical practices and evidence reported in the literature,
ECT today is considered a treatment option for, traditionally, depression, suicidality and catatonia, and also schizophrenia,
schizoaffective disorder, bipolar disorder, malignant neuroleptic syndrome, postpartal depression and psychosis, obsessive
compulsive disorder, post-traumatic stress disorder, dementia, etc. Recent evidence of ECT efficacy is growing stronger also in the
treatment resistant cases, for depression and psychosis. Great advantage of ECT is lack of absolute contraindications. ECT in
Croatia was introduced in clinical psychiatric practice in 1960’s in four institutions. Mainly due to stigma, but also a tendency for
shifting toward hypothesized action mechanism, ECT in Croatia has been re-named to electrostimulative therapy or
electroneuromodulatory treatment. In recent decades, the Department of psychiatry in the University Hospital Centre Zagreb (KBC
Zagreb), has continuously been practicing ECT. Our department is considered a regional leader, regarding number of patient cases
and overall experience in homeland and neighbouring countries. In the 2016, Croatian expert group, selected by the Croatian
Psychiatric Association, proposed national guidelines for the ECT. Research in ECT at our department has shown predominance of the treatment for therapy resistance in depression and psychosis. The other research at our department also showed improvement in several cognitive functions of patients after ECT application.

Keywords

ECT – history - mode of action – indications - Croatia

Hrčak ID:

262894

URI

https://hrcak.srce.hr/262894

Publication date:

22.7.2018.

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