Physical Treatments

Question 1

Why is management of physical health important in psychiatric patients?

Answer 1

Important as need to rule out organic causation

Patients with major mental illness have an increased standardised mortality ratio

Patients are on longer term medications and often symptoms of their mental disorder may limit their access to physical health care service either directly or indirectly

Question 2

What is electroconvulsive therapy?

Answer 2

Process whereby a patient is prepared, consented, is given a light general anaesthetic and muscle relaxant, has a seizure induced by apparatus generating an electrical stimulus and is recovered safely, for the purposes of treating specific mental health conditions

Question 3

Who is ECT for?

Answer 3

Patients who do not respond to pharmacological treatments

Patients who are unwilling or unable to tolerate the side effects of effective drug treatments

Patient who in the past responded well to ECT but not to antidepressants

Question 4

Relative contraindications to ECT

Answer 4

Raised intracranial pressure (absolute?)

Cerebral aneurysm

History of cerebral haemorrhage

Recent myocardial infarction

Cardiac arrhythmias

Brain tumours

Demyelinating diseases

Acute respiratory infection

Question 5

Short-term side effects of ECT

Answer 5

Headache

Nausea

Short term memory impairment

Memory loss of events prior to ECT

Cardiac arrhythmia

Question 6

Long-term side effects of ECT

Answer 6

Impaired memory