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Schizophrenia is the second most common diagnostic disorder that ECT is used for, although only 1% of hospital admissions of persons diagnosed with schizophrenia receive ECT - compared to 13% of affective disorder (Chanpattana & Kramer, 2003).
History and Procedure:
ECT was introduced as a treatment for Schizophrenia in the 1930's. Studies have described the ECT techniques; Initially the patient is given premedications such as anesthesia. A brief impulse machine is used to induce seizures on the patient that are monitored by an Electroencephalograph (EEG). The doctor should personalize this treatment to the patient's own seizure threshold and demographics, for example, men and woman will require different impulse strengths (Tang & Ungvari, 2003).
Research:
ECT has been described as an effective treatment for those people who experience the most severe disabling symptoms of schizophrenia. This writer reviewed two studies that tested ECT treatment for people diagnosed with Schizophrenia, who were also identified as being nonresponsive to medications. These two studies' research methodology and generalisability of findings were limited in some ways, e.g., Chanpattana & Kramer (2003)'s study excluded clients who were substance abusers and only used subjects that had a history of ECT treatment.
Considerations:
- Some medications may work better in conjunction with ECT.
- These two studies found improved ratings in psychopathology, quality of life, and social functioning; and a decrease in the overall positive and negative symptomology (Chanpattana & Kramer, 2003; Tang & Ungvari, 2003).
- If you are involved in ECT in anyway, such as a clinician, doctor, self-referral, or family member, remember to review the possible side effects of this treatment wtih the specialist. Some side effects listed in the evidence-based studies, e.g., memory impairment, headaches, dizziness, and pain in the intravenous site, etc.
Implications for Social Work:
Overall, the main reasons why people "opt out" of the ECT treatment in studies is seems to be due to 1) fear of the treatment, 2) denial of the illness, 3) fear of complications, 4) paranoid symptoms that inhibits the person from trusting the treatment team and ECT and 5) a lack of confidence in the therapeutic effects of ECT. It is important to provide education about what the patient should expect to experience, feel and why it is done. ECT is routinely done in medical settings and this procedure offers the opportunity for social workers, psychiatrists, psychologists, nurses, medical doctors and the client(s) to form a therapeutic, knowledgable alliance.
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Consider This:
The PORT study recommended Electroconvulsive Therapy (ECT) to be used for people diagnosed with Schizophrenia who do not respond to antipsychotic therapy. Numerous studies recommend ECT as a complementary therapy.
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