Literature Review

The depression is one of the common health disorder which impact on the functions of the human body system. Such kind of problem increases the issue of disability in the patients and increases the rate of sadness and loss of interest. There are many consumers are suffering from this issue and around 300 million individuals are affected due to depression mental disorder globally (Mayor, 2003). World health organization suggested that electroconvulsive therapy play a major role in the reduction of depression from patients (Hausner, et al., 2011). This study objective is to understand the concept of electroconvulsive therapy and analyse the effectiveness of the ECT process on patients who are suffering from the issue of depression (Mayor, 2003). The ECT is defined as the electroconvulsive therapy which is a more secure process for controlling and monitoring the level of depression in the consumers (Little, 2009). This paper focuses on electroconvulsive therapy and identifies the importance of this therapy in the reduction of depression mental disorder. For better understanding, a literature review will be added that collects the relevant data from previous researches and analysis of the viewpoints of other experts. This report is divided into major four sections, for example, method, background, discussion and literature review.

In this research study, an electronic search was adopted using the UTAS library and relevant information gathered from the peer reviewed articles, CINAHL database, EBSCO database and health resources like Medline and nursing edition. The theoretical information is collected from the previous investigation and online sources and a literature review is conducted in order to analyse the opinions of the other investigator on the ECT process. To ensure that the literature section was relevant to the research topic there are numbers of articles can be discussed and reviewed. Moreover, the review of the reference lists of selected journal papers was also added in this investigation. The selection of the literature search was based on the research topic that is the effectiveness of the ECT process on patients who are facing the issue of depression. However, the analysis section of the literature review is added in the appendix with the key findings and objectives of the researchers (Hausner, et al., 2011). In this paper around 25 articles are reviewed and improved the effectiveness of the research by analysing the results obtained by the other investigators. 

The term depression refers to the mental health disorder which negatively impacts on the feeling and other functions of the individual body (Van Schaik, et al., 2012
). According to the world health organization, depression is a very common health issue which is growing rapidly and in the year 2015 around 10 million individuals were suffered from the depression problem in Australia Gómez-Arnau, et al., (2018). Sadness, stress and loss of interest all these are very common signs or symptoms of depression disorder (Little, 2009). For reducing the impact of the depression on the human body a new approach has been developed which is called as the electroconvulsive therapy.

Methodology

This process is a very safe and controlled technique for the reduction of the depression and other mental health disorders which have not responded to other treatments. Depression affects the 15 million Australian and making it the major cause of disability in the Australian people but it is very difficult to reduce this illness (Nordanskog, et al., 2010). The electroconvulsive therapy helps patients for improving their health and maintaining the psychological diseases (Van Schaik, et al., 2012
). In this modern era, many health care providers suggest and use the ECT process because it has the potential to identify the key aspects that increase the mental health disorders in consumers and improve the health of the patient (Nordanskog, et al., 2010).

Such kind of process is more valuable often underuse treatment which could help consumers for managing and reducing the signs and symptoms of the depression illness. Moreover, this process is more secure for pregnant ladies who are suffering from the depression problem and provide positive results to the patients. More than 100,000 individuals every year receive ECT treatment in Australia and improve the health of the patient by 70 Stern, et al., (1999). This study highlights the importance of electroconvulsive therapy and how this treatment method helps patients who are facing the problem of depression (Jelovac, Kolshus, and McLoughlin, 2013). The process of ECT method is completed under general anaesthesia in which less electric current transfer through the brain of a patient that triggers the seizure. Moreover, the ECT method changes the chemistry of the brain which can help depressive patients for reducing the signs and symptoms of depression. Mainly, such kind of treatment process is used when the other techniques are unsuccessful for reducing the impact of mental health disorders. However, in the process of ECT treatment, the high dose of electric current was administered without anaesthesia and reduces the early signs of the depression from the patient body. Recent investigation about ECT therapy identified that electroconvulsive therapy is one of the best options when medication is not tolerated and other forms of treatments have not worked (Jelovac, Kolshus, and McLoughlin, 2013).

The electroconvulsive is a kind of treatment technique which is used for decreasing the rate of depression in patients. It is a very common topic for the research and many authors provided their views on the importance of electroconvulsive therapy in depressive patients. This section will discuss the working principle of the ECT treatment method and collect the relevant data from the previous investigations and articles.

Background

According to Gómez-Arnau, et al., (2018) the electroconvulsive is one of the best approaches for identifying the key factors which increase the issue of depression in the consumers. This journal paper highlighted the effectiveness of the ECT method and identified that most cases of the depression are treated and diagnosed in the primary care which does not provide proper treatment for which health communities use ECT process. With the help of this technique, patients can improve their health and they can easily reduce the symptoms of depression disorder (Nordanskog, et al., 2010). From this journal paper, it has been concluded that the ECT process transfers the electric current with the help of electrodes which are placed on the exterior of the skull. The researcher also suggested that the utilization of sham ECT method is widely viewed as the treatment technique for decreasing the rate of depression from the human body.

Stern, et al., (1999) identified that the electroconvulsive therapy is a very common process which is used by the doctors for maintaining the problem of depression in consumers and it is more than 85% effective technique in the case of depression disorder. It is also noted that the process of electroconvulsive therapy supports effective results more quickly as compared to other treatments and medicines. In which the researcher conducted a survey in order to analysis the viewpoints of other consumer’s and collected the outcomes of previous investigation (Jelovac, Kolshus, and McLoughlin, 2013). It is concluded that there is no evidence based process which demonstrates the ECT is better as compared to the other but it is analysed that it help depressive patients and promote their health in an effective manner.

There are several individuals that suggested that the ECT technique has mainly temporary effect on the human memory that means it effectively improve the memory of consumers which help patients for monitoring the level of depression (Spaans, et al., 2013). According to the National Health Service because of information diversity, when ECT is increased with the consumer as a capable treatment then it balances the level of depression and maintains patient health in an effective manner (Van, et al., 2015). The major aim of the ECT process is to identify the key elements from the human body that increase the rate of depression and improve the level of health by managing patient’s problems. 

Salzman, Wong, and Wright, (2002) provided their opinions on this topic and evaluated that electroconvulsive therapy has the ability to improve the health of a patient who is suffering from depression and it is 85% effective technique for the reduction of other mental health disorders. This journal paper provided in-depth analysis about the ECT technique and the author conducted a survey with 137 patients who were suffering from the depression. During this survey around 40% of patients provided a positive response about ECT and suggested that with the help of electroconvulsive treatment consumers can reduce the symptoms of the depression disease (Merkl, Heuser, and Bajbouj, 2009). From this investigation, it is analysed that the process of ECT treatment equally enhances signs and symptoms of depression as determined by PHQ-9 in a patient who faced the issue depression (Van, et al., 2015). The data and facts identified by the research indicate that the ECT is an effective approach which can be adopted by the health care providers in order to maintain the early signs of mental health illnesss.

Discussion

Moser, Lobato, and Belmonte-de-Abreu, (2005) identified that memory impairment is one of the major side impacts of the ECT treatment which can increase the rate of depression in some patients. This study provided the fundamental concept of ECT therapy and justified the overall effectiveness of this technique in patients who are suffering from depression. In which researcher developed and implemented a survey of 17 normal consumers and 17 patients with the mental health disease.

The depressive patients were tested in the major three intervals such as 24 to 48 hours prior, 24-48 hours which follow the initial stage of ECT and 24 to 48 hours which follow the complete stages of the ECT treatment. The ability of the consumer for reducing the health disorder can be improved with the help of motivation and primary care but if primary care does not reduce patient problem then the ECT process can be used.

According to Wells, et al., (2018) the term ECT is defined as the electroconvulsive therapy which is a part of medical treatment and it is used in the health care systems for consumers that suffer from the psychological problems, for example, depression. Mainly such kind of treatment process includes the electrical stimulation of the human brain while the patient is under the anaesthesia and specialists transfer the electric current in the body of the patient (Sienaert, et al., 2009). This paper described the working principle of ECT therapy and provided only theoretical information about the ECT by which students can understand the significance of ECT in the field of depression.

The researcher analysed that the technique of ECT is highly effective for the relief of depression and other health related issues. The clinical evidence collected by the researcher shows that for the consumer with the uncomplicated but few depression symptoms, this process will deliver substantial development in more than 80% of consumers (Heijnen, et al., 2010). Such kind of process is also utilized for treating a patient with catatonia and managing the functions of their body system. It is concluded that the treatment process of the ECT does not take more time as compared to the medicine and other methods and it is also helpful for the long term psychological disease. 

Lee, et al., (2019) highlighted that for the prevention of depressive patients the electroconvulsive therapy is the very best technique and many hospitals and care providers uses this process. This paper identified the advantage and disadvantages of the ECT process with respect to the patient who has long term symptoms of the depression (Sackeim, et al., 2009). The main problem of this technique is that sometimes it increases the problem of memory in patients which means consumers can lose their memory during the electric shocks.

ECT and Depression

According to Vakil, et al., (2000) in the initial stage of the patient treatment the ECT treatment transferred through the various kinds of technical refinements, for example, muscular relaxation, preorygenation and short term anaesthesia. From this paper, it is noted that the use of ECT therapy has increased by the 39% in last five years and many health care services in Australia suggest the ECT treatment for depressive and other psychological patients. The researcher conducted a literature review for better understanding and added the results and findings of the other investigators on the ECT process for the treatment of depression problem. This research paper focused on the ECT therapy and discussed that the major significant adverse impact of the electroconvulsive is the memory deficit that indicates as the anterograde amnesia, post-ictal confusion (Spaans, et al., 2015). Therefore, with the help of electroconvulsive therapy consumers can manage their health and they can reduce the side effect of the medicine and signs of depression. It is observed that such kind of treatment process is used whenever a patient has depression disease from the last 3 to 4 months.

Dierckx, et al., (2012) investigated that electroconvulsive therapy is one of the advanced treatment methods for depression and other psychological disorders that involve highly protoclized processes. It is observed that the overall process of the Electroconvulsive therapy can be done within the 10 minutes where the electric current pass through the body of the patient (Nordenskjöld, von Knorring, and Engström, 2012). Once anaesthesia and neuromuscular blocker are evaluated then the ECT process reduces the impact of the depression from the patient body and manages the functions of the patient’s body. 

The effectiveness of ECT therapy can be increased with the help of ventilation and patient who suffers from depression can adopt this process because it is more than 90% effective. From this investigation, it has been identified that Electroconvulsive therapy allows patients to manage the health-related issues and it has the capability to provide better treatment to the patients (Hallam, Smith, and Berk, 2009). According to Bailine, et al., (2010) at the time of Electroconvulsive therapy the value of seizure threshold increased and the amount of seizure duration decreases. This paper discussed the effectiveness of Electroconvulsive therapy in the improvement of patient’s health who is suffering from mental illness like depression (Kayser, et al., 2011). Therefore, it is suggested that the process of Electroconvulsive therapy is more efficient as compared to the drug treatment for the depression illness but it is also associated with memory impairment.  

Working Principle of ECT

Conclusion 

From the above discussion, it has been concluded that Electroconvulsive therapy is the best approach for reducing the problem of depression in patients. This paper focused on the concept of the ECT technique and identified the importance of Electroconvulsive therapy in patients who are facing the depression issue. It has been identified that the major problem with Electroconvulsive therapy is that it is associated with memory impairment. This report explained the impact of Electroconvulsive therapy on depressive patients in both positive and negative manner. Furthermore, the researcher also highlighted the effectiveness of Electroconvulsive therapy on consumers that have depression or other mental illness. 

References

Bailine, S., Fink, M., Knapp, R., Petrides, G., Husain, M.M., Rasmussen, K., Sampson, S., Mueller, M., McClintock, S.M., Tobias, K.G. and Kellner, C.H., (2010) Electroconvulsive therapy is equally effective in unipolar and bipolar depression. Acta Psychiatrica Scandinavica, 121(6), pp.431-436.

Dierckx, B., Heijnen, W.T., van den Broek, W.W. and Birkenhäger, T.K., (2012) Efficacy of electroconvulsive therapy in bipolar versus unipolar major depression: a meta?analysis. Bipolar disorders, 14(2), pp.146-150.

Gómez-Arnau, J., de Arriba-Arnau, A., Correas-Lauffer, J. and Urretavizcaya, M., (2018) Hyperventilation and electroconvulsive therapy: a literature review. General hospital psychiatry, 50(1), pp.54-62.

Hallam, K.T., Smith, D.I. and Berk, M., (2009) Differences between subjective and objective assessments of the utility of Electroconvulsive therapy in patients with bipolar and unipolar depression. Journal of Affective Disorders, 112(1-3), pp.212-218.

Hausner, L., Damian, M., Sartorius, A. and Frölich, L., (2011) Efficacy and cognitive side effects of electroconvulsive therapy (ECT) in depressed elderly inpatients with coexisting mild cognitive impairment or dementia. The Journal of clinical psychiatry, 72(1), pp.91-97.

Heijnen, W.T., Birkenhäger, T.K., Wierdsma, A.I. and van den Broek, W.W., (2010) Antidepressant pharmacotherapy failure and response to subsequent electroconvulsive therapy: a meta-analysis. Journal of clinical psychopharmacology, 30(5), pp.616-619.

Jelovac, A., Kolshus, E. and McLoughlin, D.M., (2013) Relapse following successful electroconvulsive therapy for major depression: a meta-analysis. Neuropsychopharmacology, 38(12), p.2467.

Kayser, S., Bewernick, B.H., Grubert, C., Hadrysiewicz, B.L., Axmacher, N. and Schlaepfer, T.E., (2011) Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression. Journal of Psychiatric Research, 45(5), pp.569-576.

Lee, J.H., Kung, S., Rasmussen, K.G. and Palmer, B.A., (2019) Effectiveness of Electroconvulsive Therapy in Patients With Major Depressive Disorder and Comorbid Borderline Personality Disorder. The journal of ECT, 35(1), pp.44-47.

Little, A., (2009) Treatment-resistant depression. Am Fam Physician, 80(2), pp.167-72.

Mayor, S., (2003) ECT may be better than drugs for short term depression, General hospital psychiatry, 5(1), pp.4-6.

Merkl, A., Heuser, I. and Bajbouj, M., (2009) Antidepressant electroconvulsive therapy: mechanism of action, recent advances and limitations. Experimental neurology, 219(1), pp.20-26.

Effectiveness of ECT

Moser, C.M., Lobato, M.I. and Belmonte-de-Abreu, P., (2005) Evidence of the effectiveness of electroconvulsive therapy in the psychiatric practice. Revista de Psiquiatria do the Rio Grande do Sul, 27(3), pp.302-310.

Nordanskog, P., Dahlstrand, U., Larsson, M.R., Larsson, E.M., Knutsson, L. and Johanson, A., (2010) Increase in hippocampal volume after electroconvulsive therapy in patients with depression: a volumetric magnetic resonance imaging study. The journal of ECT, 26(1), pp.62-67.

Nordenskjöld, A., von Knorring, L. and Engström, I., (2012) Predictors of the short-term responder rate of electroconvulsive therapy in depressive disorders-a population based study. BMC psychiatry, 12(1), p.115.

Sackeim, H.A., Dillingham, E.M., Prudic, J., Cooper, T., McCall, W.V., Rosenquist, P., Isenberg, K., Garcia, K., Mulsant, B.H. and Haskett, R.F., (2009) Effect of concomitant pharmacotherapy on electroconvulsive therapy outcomes: short-term efficacy and adverse effects. Archives of general psychiatry, 66(7), pp.729-737.

Salzman, C., Wong, E. and Wright, B.C., (2002) Drug and ECT treatment of depression in the elderly, 1996–2001: a literature review. Biological Psychiatry, 52(3), pp.265-284.

Sienaert, P., Vansteelandt, K., Demyttenaere, K. and Peuskens, J., (2009) Randomized comparison of ultra-brief bifrontal and unilateral electroconvulsive therapy for major depression: clinical efficacy. Journal of Affective Disorders, 116(1-2), pp.106-112.

Spaans, H.P., Sienaert, P., Bouckaert, F., van den Berg, J.F., Verwijk, E., Kho, K.H., Stek, M.L. and Kok, R.M., (2015) Speed of remission in elderly patients with depression: electroconvulsive therapy v. medication. The British Journal of Psychiatry, 206(1), pp.67-71.

Spaans, H.P., Verwijk, E., Comijs, H.C., Kok, R.M., Sienaert, P., Bouckaert, F., Fannes, K., Vandepoel, K., Scherder, E.J., Stek, M.L. and Kho, K.H., (2013) Efficacy and cognitive side effects after brief pulse and ultrabrief pulse right unilateral electroconvulsive therapy for major depression: a randomized, double-blind, controlled study. The Journal of clinical psychiatry, 74(11), pp.e1029-36.

Stern, L., Dannon, P.N., Hirschmann, S., Schriber, S., Amytal, D., Dolberg, O.T. and Grunhaus, L., (1999) Aminophylline increases seizure length during electroconvulsive therapy. The journal of ECT, 15(4), pp.252-257.

Vakil, E., Grunhaus, L., Nagar, I., Ben-Chaim, E., Dolberg, O.T., Dannon, P.N. and Schreiber, S., (2000) The effect of electroconvulsive therapy (ECT) on implicit memory: skill learning and perceptual priming in patients with major depression. Neuropsychologia, 38(10), pp.1405-1414.

Van Schaik, A.M., Comijs, H.C., Sonnenberg, C.M., Beekman, A.T., Sienaert, P. and Stek, M.L., (2012) Efficacy and safety of continuation and maintenance electroconvulsive therapy in depressed elderly patients: a systematic review. The American Journal of Geriatric Psychiatry, 20(1), pp.5-17.

Van Waarde, J.A., Scholte, H.S., Van Oudheusden, L.J.B., Verwey, B., Denys, D. and Van Wingen, G.A., (2015) A functional MRI marker may predict the outcome of electroconvulsive therapy in severe and treatment-resistant depression. Molecular psychiatry, 20(5), p.609.

Wells, K., Scanlan, J.N., Gomez, L., Rutter, S., Hancock, N., Tuite, A., Ho, J., Jacek, S., Jones, A., Mehdi, H. and Still, M., (2018) Decision making and support available to individuals considering and undertaking electroconvulsive therapy (ECT): a qualitative, consumer-led study. BMC psychiatry, 18(1), p.236.