Electroconvulsive Treatment in Therapy-Resistant or Acute Life-Threatening Psychiatric Disease

DOI: 10.3238/zfa.2017.0255-0259

german translation / full article

Michael Grözinger

Keywords: mental disorder treatment resistance multiplier referring physician family practitioner

Background: Electroconvulsive therapy (ECT) has given proof for decades of being a life-saving alternative for patients with severe mental diseases who do not respond sufficiently to psychopharmacology and psychotherapy. Misleadingly, this method is often described as outdated not only by the lay public, but also by many doctors. This overview is therefore addressed to all colleagues who in their role as multipliers, referring physicians or ECT specialists have a chance to work against the chronification of mental disease.

Methods: This article summarizes guidelines regarding ECT by international medical societies, including those by the Austrian and by the German Association for Psychiatry (Österreichische Gesellschaft für Psychiatrie und Psychotherapie, ÖGPP and Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde, DGPPN). In addition, a pragmatic PubMed literature search was conducted on special aspects.

Results: The unique feature of ECT has always been its superior efficacy in the treatment of severe mental disorders. The development from electroshock therapy of the 1930s to the ECT of today has been driven equally by continued adaptation to the changing psychiatric environment and by technical innovations. This process has resulted in a more patient-oriented practice and reduced side effects.

Conclusions: ECT is a highly effective, modern and safe treatment of severe mental diseases. The side effects are rather moderate when compared to the natural progress of the diseases treated. The method should be used evidence-based and not as a last resort. Therefore, patients should be informed timely and adequately.

(State: 19.06.2017)

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