ELEKTROKONVULZİF TERAPİ ALAN HASTALARIN ÖZNEL DENEYİMLERİNİN ARAŞTIRILMASI

Year 2024, , 361 - 369, 18.07.2024

Seyhan Oktar , İmran Gökçen Yılmaz-karaman , Elif Baştürk Karımmoajenı , Çınar Yenilmez , Cennet Yastıbaş

https://doi.org/10.18229/kocatepetip.1364858

Abstract

AMAÇ: Elektrokonvulzif terapi (EKT) 1938 yılından bu yana depresyon, şizofreni, bipolar bozukluk başta olmak üzere birçok psikiyatrik bozuklukta sıklıkla kullanılan bir tedavi yöntemi olmuştur. EKT, ilk uygulanılmaya başladığı yıllardan bu yana, en tartışmalı bir tedavi yöntemlerden birisi olma konumunu sürdürmektedir. Literatürde EKT hakkında yapılmış birçok çalışma bulunmasına rağmen, hastaların öznel deneyimlerini inceleyen çalışmalar çok az sayıdadır. Bu çalışmanın amacı, EKT uygulanan hastaların öznel deneyimlerini araştırmaktır.
GEREÇ VE YÖNTEM: Araştırma evrenini 2014 yılından sonra Eskişehir Osmangazi Üniversitesi Tıp Fakültesi’nde EKT uygulanan 40 hasta oluşturmakta olup, kriterlere uyan ve çalışmaya katılmayı kabul eden 11 hasta çalışmaya dahil edilmiştir. Hastalara Sosyodemografik ve Klinik veri formu uygulanmış, bu formda katılımcının yaş, eğitim, medeni durum gibi sosyodemografik özellikleri, hastalık tanısı, EKT uygulanma sebebi, EKT uygulamasına dair değişkenler araştırılmış ve katılımcılara öznel EKT deneyimi ile ilgili açık ve kapalı uçlu sorular yöneltilmiştir.
BULGULAR: EKT uygulanan hastaların 4’ünün tanısı unipolar depresyon (%36.4), 3’ünün bipolar bozukluk (%27.3), 2’sinin şizofreni (%18.2) ve yine 2’sinin tanısı şizoaffektif bozukluktu (%18.2). Genel değerlendirme soruları sonucunda, hastaların 7’sinin (%63.6) EKT’nin faydasının zararından daha fazla olduğunu ifade ettiği, hastaların 10’unun (%90.9) hastalık belirtilerinin EKT’den daha olumsuz bir deneyim olduğunu belirttiği görülmüştür.
SONUÇ: Hastaların büyük çoğunluğunun EKT’den memnun kaldığı görülmüştür. Topluma ve sağlık çalışanlarına EKT’nin daha gerçekçi şekilde tanıtılması, bu güvenli ve etkili yöntemin daha fazla kullanılmasına yol açabilir.

Keywords

Elektrokonvulzif tedavi, Elektroşok tedavisi, Depresyon, Şizofreni, Bipolar bozukluk

INVESTIGATION OF THE SUBJECTIVE EXPERIENCES OF PATIENTS TAKING ELECTROCONVULSIVE THERAPY

Abstract

OBJECTIVE: Electroconvulsive therapy (ECT) has been a frequently used treatment modality for many psychiatric disorders, especially depression, schizophrenia, and bipolar disorder, since 1938. Since its first application, ECT has been one of the most controversial treatment modalities. Although there are many studies on ECT in the literature, very few studies examine patients' subjective experiences. This study aimed to investigate the subjective experiences of patients undergoing ECT.
MATERIAL AND METHODS: The research population consisted of 40 patients who underwent ECT at Eskişehir Osmangazi University Faculty of Medicine after 2014, and 11 patients who met the criteria and agreed to participate in the study were included in the study. A Sociodemographic and Clinical Data Form was administered to the patients, in which sociodemographic characteristics such as age, education, marital status, disease diagnosis, the reason for ECT, and variables related to ECT administration were investigated, and open-ended and closed-ended questions about the subjective ECT experience were asked to the participants.
RESULTS: Of the patients who underwent ECT, 4 had unipolar depression (36.4%), 3 had bipolar disorder (27.3%), 2 had schizophrenia (18.2%), and 2 had schizoaffective disorder (18.2%). As a result of the general evaluation questions, it was observed that 7 (63.6%) of the patients stated that the benefits of ECT were more than the harms, and 10 (90.9%) of the patients stated that the symptoms of the disease were a more negative experience than ECT.
CONCLUSIONS: The majority of patients were satisfied with ECT. A more realistic introduction of ECT to the public and healthcare professionals may lead to more use of this safe and effective method.

Keywords

Electroconvulsive therapy, Electroshock therapy, Depression, Schizophrenia, Bipolar disorder

References

• 1. Zeren T, Tamam L, Evlice YE. Elektrokonvülsif Terapi (EKT): Bir Genel Değerlendirme. Arşiv Kaynak Tarama Dergisi. 2003;12(4):340-78.
• 2. Cattaneo CI, Ressico F, Fornaro M, Fazzari G, Perugi G. The shocking attitude toward electroconvulsive therapy in Italy. CNS Spectr. 2022;27(2):131-3.
• 3. Kellner CH, Obbels J, Sienaert P. When to consider electroconvulsive therapy (ECT). Acta Psychiatr Scand. 2020;141(4):304-315.
• 4. Golenkov A, Ungvari GS, Gazdag G. Public attitudes towards electroconvulsive therapy in the Chuvash Republic. Int J Soc Psychiatry. 2012;58(3):289-94.
• 5. Khan G, Nazar Z, Haq MMU, Hussain MI. Assessment of attitudes of patients with psychiatric disorders regarding electroconvulsive therapy as a treatment option. Pak J Med Sci. 2020;36(3):565-8.
• 6. Zong QQ, Qi H, Wang YY, et al. Knowledge and attitudes of adolescents with psychiatric disorders and their caregivers towards electroconvulsive therapy in China. Asian J Psychiatr. 2020;(49):1-5.
• 7. Ezeobele IE, Ekwemalor CC, Pinjari OF, et al. Current knowledge and attitudes of psychiatric nurses toward electroconvulsive therapy. Perspect Psychiatr Care. 2022;58(4):1967-72.
• 8. Ithman M, O'Connell C, Ogunleye A, et al. Pre- and Post-Clerkship Knowledge, Perceptions, and Acceptability of Electroconvulsive Therapy (ECT) in 3rd Year Medical Students. Psychiatr Q. 2018;89(4):869- 80.
• 9. McFarquhar TF, Thompson J. Knowledge and attitudes regarding electroconvulsive therapy among medical students and the general public. J ECT. 2008;24(4):244-53.
• 10. Harkın Gemicioğlu Ş. Hemşirelik Son Sınıf Öğrencilerinin Elektrokonvülsif Tedavi Hakkında Bilgi ve Tutumlarının Belirlenmesi: Gözleme Dayalı Kesitsel Bir Çalışma. J Higher Edu Sci. 2022;12(1):102-10.
• 11. Mausling MB, Macharia M, Jordaan GP. Junior medical students knowledge about and attitudes towards electroconvulsive therapy in a South African setting. S Afr J Psychiatr. 2017;(23):1-6.
• 12. Aki OE, Ak S, Sonmez YE, Demir B. Knowledge of and attitudes toward electroconvulsive therapy among medical students, psychology students and the general public. J ECT. 2013;29(1):45-50.
• 13. Virit O, Ayar D, Savas HA, Yumru M, Selek S. Patients and their relatives attitudes toward electroconvulsive therapy in bipolar disorder. J ECT. 2007;23(4):255-9.
• 14. Ercis M, Seçkin M, Ayık B, Üçok A. Correlates of Patient Satisfaction in Psychiatric Inpatient Care: A Survey Study from a Tertiary Hospital in Turkey. J Psychosoc Nurs Ment Health Serv. 2021;59(4):38-47.
• 15. Sönmez S, İlgün G. Nitel Araştırma Yöntemlerinin Sağlık Hizmetleri Bağlamında İncelenmesi. Balıkesir Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2018;21(40):375-400.
• 16. Ertugay F. Sosyal Bilimlerde Nitel Araştırma/Esnek Desen Araştırması: Alana İlişkin Zorluklar, Sorunlar ve İmkânlar. Nitel Sosyal Bilimler Dergisi. 2019;1(1):48-68.
• 17. Malekian A, Amini Z, Maracy MR, Barekatain M. Knowledge of attitude toward experience and satisfaction with electroconvulsive therapy in a sample of Iranian patients. J ECT. 2009;25(2):106-12.
• 18. Guy W. ECDEU Assessment Manuel For Psychopharmacology.https://https://archive.org/details/ecdeuassessmentm1933guyw/page/417/mode/1up Erşim Tarihi: 01.07.2010.
• 19. Erlingsson C, Brysiewicz P. A hands-on guide to doing content analysis. Afr J Emerg Med. 2017;7(3):93-9.
• 20. Dowman J, Patel A, Rajput K. Electroconvulsive therapy: attitudes and misconceptions. J ECT. 2005;21(2):84-7.
• 21. Tang WK, Ungvari GS, Chan GW. Patients and their relatives knowledge of, experience with, attitude toward, and satisfaction with electroconvulsive therapy in Hong Kong, China. J ECT. 2002;18(4):207-12.
• 22. Coman A. Recipients experience with information provision for electroconvulsive therapy (ECT). BMC Psychiatry. 2022;22(1):86.
• 23. Prudic J, Peyser S, Sackeim HA. Subjective memory complaints: a review of patient self-assessment of memory after electroconvulsive therapy. J ECT. 2000;16(2):121-32.
• 24. Sigström R, Nordenskjöld A, Juréus A, et al. Long-term subjective memory after electroconvulsive therapy. BJPsych Open. 2020;6(2):1-7.
• 25. Ma ML, He LP. Electroconvulsive therapy plays an irreplaceable role in treatment of major depressive disorder. World J Clin Cases. 2022(6);16:5515-7.
• 26. Sağlam Aykut D, Civil Arslan F, Özkorumak Karagüzel E, Selçuk E, Uysal S, Tiryaki A. A General View of Electroconvulsive Therapy Practices in a Psychiatry Clinic of an University Hospital. J Clin Psy. 2017;20(2):114- 20.
• 27. Li DJ, Wang FC, Chu CS, et al. Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis. Eur Neuropsychopharmacol. 2017;27(1):29-41.
• 28. Sinclair DJM, Zhao S, Qi F, Nyakyoma K, Kwong JSW, Adams CE. Electroconvulsive Therapy for Treatment- Resistant Schizophrenia. Schizophr Bull. 2019;45(4):730-2.
• 29. Chhoa KH, Chee KY. Bridging electroconvulsive therapy in schizophrenia with cognition and quality of life. Ann Acad Med Singap. 2022;51(7):390-1.
• 30. Kellner CH, Fink M, Knapp R, et al. Relief of expressed suicidal intent by ECT: a consortium for research in ECT study. Am J Psychiatry. 2005;162(5):977-82.
• 31. Grözinger M, Smith ES, Conca A. On the significance of electroconvulsive therapy in the treatment of severe mental diseases. Wien Klin Wochenschr. 2015;127(7-8):297-302.
• 32. Takamiya A, Sawada K, Mimura M, Kishimoto T. Attitudes Toward Electroconvulsive Therapy Among Involuntary and Voluntary Patients. J ECT. 2019;35(3):165-9.
• 33. Zengin SÜ, Salihoğlu Z. Elektrokonvülzif Terapi Uygulamalarında Anestezi Türkiye Klinikleri J Psychiatry- Special Topics 2018;11(1):75-9.
• 34. Eggleston K, Porter R. Subjective memory impairment after electroconvulsive therapy - potentially modifiable?. BJPsych Open. 2020;6(3):1-2.
• 35. Semkovska M, McLoughlin DM. Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis. Biol Psychiatry. 2010;68(6):568-77.
• 36. Semkovska M, McLoughlin DM. Measuring retrograde autobiographical amnesia following electroconvulsive therapy: historical perspective and current issues. J ECT. 2013;29(2):127-33.
• 37. Mohn C, Rund BR. Maintained Improvement of Neurocognitive Function in Major Depressive Disorders 6 Months after ECT. Front Psychiatry. 2016;(7):1-6.
• 38. Sackeim HA, Prudic J, Fuller R, et al. The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology. 2007;32(1):244-54.
• 39. Chakrabarti S, Grover S, Rajagopal R. Electroconvulsive therapy: a review of knowledge, experience and attitudes of patients concerning the treatment. World J Biol Psychiatry. 2010;11(3):525-37.
• 40. Rajagopal R, Chakrabarti S, Grover S. Satisfaction with electroconvulsive therapy among patients and their relatives. J ECT. 2013;29(4):283-90.
• 41. Sienaert P. Based on a True Story? The Portrayal of ECT in International Movies and Television Programs. Brain Stimul. 2016;9(6):882-91.
• 42. Demir S, Bulut M, İbiloğlu AO, Güneş M, Şimsek Ş, Sır A. Psikiyatri Kliniğinde Yatan Hastaların Komorbit Somatik Hastalıkları. Mustafa Kemal Üniversitesi Tıp Dergisi. 2016;7(26):1-10.
• 43. Döngel Demirel B, Tamam L, Kır G. Şizofrenide Görülen Tıbbi Durumlar. Psikiyatride Güncel Yaklaşımlar. 2017;9(3):363-78.
• 44. Cansız A, İnce B, Altınbaş K, Kurt E. Duygudurum kliniğinde takip edilen bipolar bozukluk tanılı hastalarda ölüm nedenlerinin değerlendirilmesi. J Clin Psy. 2018;21(4):389-96 .
• 45. Helvacı Çelik F, Hocaoğlu Ç. Major Depresif Bozukluk Tanımı, Etyolojisi ve Epidemiyolojisi: Bir Gözden Geçirme. Çağdaş Tıp Dergisi. 2016;6(1):51-66.
• 46. McDonald A, Walter G. Hollywood and ECT. Int Rev Psychiatry. 2009;21(3):200-6.