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노년기 정신장애의 전기경련치료

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Author(s)
Eun-Jeong JooHee Cheol KimUng Gu KangNam Young LeeSeung Hyun ParkJung Min KimYong Sik KimIn Won Chung
Keimyung Author(s)
Kim, Hee Chul
Department
Dept. of Psychiatry (정신건강의학)
Journal Title
생물정신의학
Issued Date
2020
Volume
27
Issue
2
Keyword
Mental disorderElderlyElectroconvulsive therapy
Abstract
Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.
Alternative Title
Electroconvulsive Therapy for Psychiatric Disorders in Elderly Adults
Keimyung Author(s)(Kor)
김희철
Publisher
School of Medicine (의과대학)
Citation
Eun-Jeong Joo et al. (2020). 노년기 정신장애의 전기경련치료. 생물정신의학, 27(2), 42–57. doi: 10.22857/kjbp.2020.27.2.002
Type
Article
ISSN
2005-7571
Source
https://www.kci.go.kr/kciportal/landing/article.kci?arti_id=ART002643950
DOI
10.22857/kjbp.2020.27.2.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42911
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Psychiatry (정신건강의학)
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