Electroconvulsive therapy (ECT) is a treatment in which one of the following conditions?
Correct Answer E:
Electroconvulsive therapy (ECT) is indicated in severe suicidal depression, depression with agitation or psychomotor retardation, or depression during pregnancy is often treated with ECT if drugs are ineffective. Patients who have stopped eating may need ECT to prevent death. ECT is also effective for psychotic depression. Response to 6 to 10 ECT treatments is usually dramatic and may be lifesaving. Relapse after ECT is common, and drug therapy is often maintained after ECT is stopped.
A 76-year-old white male with a history of recurrent depression has recently become more depressed and developed psychotic features. His symptoms have not responded to antidepressants and antipsychotic agents, prescribed by his psychiatrist. The psychiatrist has recommended electroconvulsive therapy (ECT) for the patient. The patient’s family visits you to ask for your opinion and recommendations regarding ECT in this individual.
In your consultation with this family, which one of the following would be accurate advice regarding ECT?
Correct Answer A:
Electroconvulsive therapy (ECT) has a more than 60-year history for the treatment of severe depression. There has been no evidence of brain damage secondary to ECT. The most common side effect is reversible short-term memory loss. Dementia is not listed as a side effect. Response rates are generally in the 60%-90% range.
Patients with which one of the following conditions are at increased risk for complications from electroconvulsive therapy for depression?
There are no absolute contraindications to electroconvulsive therapy (ECT), but more complications are seen in patients with a history of recent cerebral hemorrhage, stroke, or increased intracranial pressure. The efficacy of ECT may be reduced in patients who have not responded to oral antidepressants.
Exposure therapy has been shown to be the best treatment for which one of the following?
Because many phobic disorders involve avoidance, exposure therapy, which is a form of psychotherapy, is the treatment of choice. With structure and support from a clinician who prescribes exposure homework, patients seek out, confront, and remain in contact with what they fear and avoid until their anxiety is gradually relieved through a process called habituation. Exposure therapy helps > 90% of those who carry it out faithfully and is almost always the only treatment needed for specific phobias. Cognitive-behavioral therapy is effective for agoraphobia and social phobia.
Cognitive-behavioral therapy involves teaching patients to recognize and control their distorted thinking and false beliefs as well as instructing them on exposure therapy. For example, patients who describe acceleration of their heart rate or shortness of breath in certain situations or places learn by being repeatedly exposed to those situations that their worries about having a heart attack are unfounded and are taught to respond instead with slow, controlled breathing or other methods that promote relaxation.
The following therapies may be used in the management of chronic pain, except:
Correct Answer C:
Treatment of chronic pain usually involves medicines and therapy. Several types of therapy can help ease pain. Physical therapy (such as stretching and strengthening activities) and low-impact exercise (such as walking, swimming or biking) can help reduce the pain. However, exercising too much or not at all can hurt chronic pain patients. Occupational therapy teaches how to pace yourself and how to do ordinary tasks differently so you won't hurt yourself. Behavioral therapy can reduce pain through methods (such as meditation and yoga) that help you relax. It can also help decrease stress.
Biofeedback, a method of consciously controlling a body function that is normally regulated automatically by the body, such as skin temperature. Biofeedback is a method that uses the mind to control a body function that the body normally regulates automatically, such as skin temperature, muscle tension, heart rate, or blood pressure.
Lifestyle changes such as getting daily exercise, eating a healthy diet, getting enough sleep, and trying complementary therapies and cognitive-behavioral therapy may help you reduce the pain or prevent it from getting worse. Cognitive behavioral therapy (CBT) teaches relaxation techniques, stress management, and other ways to help you cope with pain. Physical, psychological, and social factors all play a role in pain management.
Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders.
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