Maintenance Electroconvulsive Therapy Is an Essential Medical Treatment for Patients With Catatonia: A COVID-19 Related Experience
Autor: | Daniel F. Maixner, Neera Ghaziuddin, Wael Shamseddeen, Hannah Reynard, Priyanka Reddy, Tareq Yaqub |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Pediatrics
medicine.medical_specialty maintenance electroconvulsive therapy Coronavirus disease 2019 (COVID-19) Catatonia medicine.medical_treatment RC435-571 maintenance ECT behavioral disciplines and activities electroconvulsive therapy Gastrostomy feeding tube 03 medical and health sciences 0302 clinical medicine Electroconvulsive therapy Intellectual disability medicine Psychiatry Medical treatment business.industry Aggression Clinical course Brief Research Report medicine.disease 030227 psychiatry developmental delay Psychiatry and Mental health medicine.symptom catatonia business 030217 neurology & neurosurgery |
Zdroj: | Frontiers in Psychiatry, Vol 12 (2021) Frontiers in Psychiatry |
ISSN: | 1664-0640 |
Popis: | Aim: Describe naturalistic clinical course over 14 weeks in a mixed adolescent and a young-adult patient group diagnosed with developmental delays and catatonia, when the frequency of maintenance electroconvulsive therapy (M-ECT) was reduced secondary to 2020 COVID-19 pandemic restrictions.Methods: Participants were diagnosed with catatonia, and were receiving care in a specialized clinic. They (n = 9), F = 5, and M = 4, ranged in age from 16 to 21 years; ECT frequency was reduced at end of March 2020 due to institutional restrictions. Two parents/caregivers elected to discontinue ECT due to concern for COVID-19 transmission. Majority (n = 8) were developmentally delayed with some degree of intellectual disability (ID). Observable symptoms were rated on a three point scale during virtual visits.Results: All cases experienced clinically significant decline. Worsening of motor symptoms (agitation, aggression, slowness, repetitive self-injury, stereotypies, speech deficits) emerged within the first 3 weeks, persisted over the 14 week observation period and were more frequent than neurovegetative symptoms (appetite, incontinence, sleep). Four participants deteriorated requiring rehospitalization, and 2 among these 4 needed a gastrostomy feeding tube.Conclusion: Moderate and severe symptoms became apparent in all 9 cases during the observation period; medication adjustments were ineffective; resuming M-ECT at each participant's baseline schedule, usually by week 7, resulted in progressive improvement in some cases but the improvement was insufficient to prevent re-hospitalization in 4 cases. In summary, rapid deterioration was noted when M-ECT was acutely reduced in the setting of COVID-19 related restrictions. |
Databáze: | OpenAIRE |
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