Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

2013 
Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT) at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP) were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02). Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5%) reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients. Objetivo: Descrever o perfil sociodemografico e clinico de pacientes submetidos a eletroconvulsoterapia (ECT) em um hospital geral universitario. Metodo: Neste estudo retrospectivo, foram revisados os prontuarios de todos os pacientes submetidos a ECT entre janeiro de 1988 e janeiro de 2008 na unidade psiquiatrica do hospital geral da Universidade Estadual de Campinas (UNICAMP). Os pacientes/familiares foram contatados por telefone para a coleta de dados de seguimento. Resultados: Um total de 200 prontuarios foram revisados. A maioria dos pacientes era do sexo feminino, com uma idade media de 39 anos e historia de hospitalizacao psiquiatrica previa. As principais indicacoes para ECT foram depressao e catatonia. Complicacoes foram observadas em menos de metade dos casos, e a maioria delas teve carater temporario e nao grave. Houve resultado psiquiatrico favoravel em 89,7% dos pacientes, especialmente os catatonicos (100%, p = 0,02). Trinta e nove por cento dos casos foram contatados por telefone, a uma media de 8,5 anos decorridos entre o procedimento e o contato. Entre estes, tres (1,5%) relataram transtornos amnesticos persistentes e 73% consideraram a ECT um bom tratamento. Conclusao: A ECT foi realizada de acordo com diretrizes internacionais. Na grande maioria dos casos, efeitos indesejaveis foram temporarios e nao graves. A resposta a ECT foi positiva na maioria dos casos, especialmente em pacientes catatonicos.
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