ECT - Depression

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  • Created by: Amy
  • Created on: 13-06-13 15:23
who thought ECT was a treatment for schizophrenia in the 1930s?
Sakel
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what did he do?
he injected insulin in schizophrenics and it let to convulsions and a coma, then mood improved
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how was ECT used in the 1930s?
misused - caused physical and emotional damage
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how are ECTs used now?
patients are given a muscle relaxant and a sedative, then electrodes are placed on their temple/s and an electric current of 70-150v is passed through the brain for up to a second. this causes a convulsion that lasts for around a minute
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what are the two forms of ECT?
bilateral and unilateral
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what is the most accepted explanation on how ECT works?
increases availability of serotonin in the brain
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when did the use of ECT decline?
with the introduction of antidepressants in the 1950s and 60s
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what did Fink find when reviewing a range of studies on ECT?
it is effective in 60% of severe depressed people
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what did Janicak find?
80% of his patients responded well to ECT whereas only 64% responded to drugs treatment
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what does this conclude?
ECT is more likely to work than drugs
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what is one of the positive aspects of ECT?
it works immediately
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why is this a good thing?
works well for suicidal people
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however, what did Sackheim find?
high relapse rates within a year
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what is the major criticism of using ECT?
it is used without any real knowledge on how it works
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what is the first of the 3 main hypotheses?
patients see ECT as a punishment for their behaviour and the use of ECT encourages them to reduce the depressed behaviour
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what is a criticism of this?
sub-convulsive shocks are equally unpleasant but do not produce the same effects
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what does this suggest
for ECT to work, the patient must have convulsions
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what is the second hypotheses?
it works because of the amnesia that accompanies it as a side effect
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what is a criticism of this?
unilateral ECT doesn't cause much memory loss and is still as effective as bilateral
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what does this suggest?
memory loss is irrelevant, it is the convulsion that is important
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what is the third hypotheses?
it causes biochemical changes by increasing the levels of noradrenaline and serotonin
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what is the most likely reason?
the last one
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what is a main criticism of using ECT?
it is inappropriate to put someone through an unpleasant experience
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what is a criticism of this?
it is less traumatic than before, the treatment is more humane with an anaesthetic and muscle relaxant so they don't hurt themselves. before, people used to break bones
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despite these improvements, why do people still see ECT as a form of abuse?
because the patient is encouraged to go through with this treatment at a time where they are very vulnerable and can't stand up for themselves
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ACCORDING TO BIOLOGICAL THERAPIES WHAT IS MORE IMPORTANT NATURE OR NURTURE?
nature
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MOST DRUG THERAPIES WERE DEVELOPED USING ANIMALS. WHY IS THIS A PROBLEM?
ethical issues
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WHY ARE THESE TREATMENTS REDUCTIONIST?
focuses on nature and simplifies a complex behaviour to biology, what if biology is a symptom?
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WHY ARE THESE TREATMENTS DETERMINISTIC?
no free will, you don't make the choice of getting better, CBT on the other hand helps people learn the skills to get better
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what did he do?

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he injected insulin in schizophrenics and it let to convulsions and a coma, then mood improved

Card 3

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how was ECT used in the 1930s?

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Card 4

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how are ECTs used now?

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Card 5

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what are the two forms of ECT?

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