Clinical Case Database / Category: Clinical Care
Electro-convulsive therapy: does it have a role in the management of depression?
Publication details
Rafael Euba MRCPsych
Foundation Years Journal, volume 3, issue 7, p.21 (123Doc Education, London, September 2009)
Abstract
A 75-year-old woman, called Mrs K, is brought to the A&E by her daughter. She has not been eating properly for some time and has lost a considerable amount of weight as a result. Mrs K takes a long time to answer questions and talks in a quiet voice. She says to the Casualty Officer that there is no point in eating because she is empty and hollow inside, and would not be able to digest the food. In any case, she adds, she is tired of life and would like to die; she feels she is a burden to her daughter and does not deserve to be looked after. In fact, she has been considering the possibility of taking an overdose of tablets in order to finish it all. Mrs K has been hearing a voice telling her that she is a wicked person and that she is going to be taken to prison. Her daughter explains that Mrs K has a previous history of depression and is on antidepressant medication: she had been on amitriptyline for a long time, but this was changed to sertraline a few weeks ago, when she started to develop her current symptoms. Her mood deteriorated after she received a letter from the council, threatening her with court action for non-payment of council tax, for which she was, in fact, exempt. Mrs K is generally independent, despite her belief that she is a burden to her daughter. She also takes medication for her blood pressure, as well as a laxative.
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Authors
Rafael Euba MRCPsych
Consultant and Senior Lecturer in Old Age Psychiatry
and Consultant with responsibility for ECT in Greenwich
Memorial Hospital
Shooters Hill
London
SE18 3RZ
References
1. R. Euba and M. Crugel. The depiction of ECT in the British press. Accepted for publication by The Journal of ECT.
2. NICE (2003a) Guidance on the Use of Electroconvulsive Therapy. Technology Appraisal 59. London: NICE. Available at http://www.nice.org.uk/Guidance/TA59.
3. Royal College of Psychiatrists. The ECT Handbook, 2nd edn. The Third Report of the Royal College of Psychiatrists' Special Committee on ECT. Edited by Allan I. F. Scott. Council Report CR128.
4. UK ECT Review Group. Efficacy and safety of electro-convulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet, 2003, 361:799–808.
5. For the law in Scotland, see Mental Health (Care and Treatment) (Scotland) Act 2003.
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