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On the significance of elektroconvulsive therapy in the treatment of severe mental diseases

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Summary

Background

Quite a few patients with severe mental diseases do not respond sufficiently to psychopharmacology and psychotherapy. For some of these, electroconvulsive therapy (ECT) offers a promising alternative. Erroneously, the method is being perceived as old fashioned by the lay public, but also by many doctors. Therefore, this overview aims at all colleagues who in their role as multipliers, referring physicians or ECT specialists can reduce the likelihood of mental disease to become chronic.

Methods

During the last decades, numerous international medical societies including the Austrian and the German Association for Psychiatry (ÖGPP and DGPPN) have pointed to the importance of ECT as a modern medical intervention. Our overview is based on these guidelines and statements. Additionally selective literature searches have been conducted concerning some key aspects.

Results

Due to its excellent efficacy, ECT is an important option in the treatment of severe mental disease. Technological innovations and continued development in the psychiatric environment determined the evolution from the electroshock of the 1930s to the ECT of today. This process led to reduced side effects and a stronger patient-oriented praxis.

Conclusions

ECT is a modern, highly effective and safe treatment of severe mental diseases with comparatively few side effects. The method should not be used as a last resort but in an evidence-based way. Patients should be informed timely and adequately about the therapeutic option.

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Acknowledgements

We would like to thank the members of the ECT-Workshop-Group and the DGPPN-section “Clinically applied stimulation techniques in psychiatry” for constructive and controversial discussions about the topics of this manuscript.

Conflict of interests

Authors declare that they have no conflict of interest in relation to this article.

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Authors and Affiliations

  1. Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany

    Michael Grözinger & Elke Stefanie Smith MSc

  2. Department of Psychiatry, Central Hospital of Bolzano, Bolzano, Italy

    Andreas Conca MD

Authors
  1. Michael Grözinger
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  2. Elke Stefanie Smith MSc
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  3. Andreas Conca MD
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Correspondence to Michael Grözinger.

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Grözinger, M., Smith, E. & Conca, A. On the significance of elektroconvulsive therapy in the treatment of severe mental diseases. Wien Klin Wochenschr 127, 297–302 (2015). https://doi.org/10.1007/s00508-015-0749-z

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