Session 9

Question 1

What are the uses of ECT?

Answer 1

• only for rapid & short term improvement
• severe depression
• other treatments have failed
• urgency (risk of suicide)
• previous good response
• prolonged or severe manic episode

Question 2

ECT procedure?

Answer 2

• uses brief square wave impulses to induce seizure (threshold 17-800mQ)
• stimulus dosing by titration
• either unilateral or bilateral (unilateral less side effects but less effective)
• General anaesthetic & muscle relaxant
• mouth guard
• seizure monitored by EEF
• x2 per week, 6-12 treatments

Question 3

ECT side effects?

Answer 3

• retrograde & anterograde amnesias
• headache
• muscle pain
• confusion
• nausea
• vertigo
• status epilepticus (prlonged seizure)
• laryngospasm
• peripheral nerve palsy

Question 4

ECT contraindications?

Answer 4

• raised ICP
• cardiac condtions
• pregancy
  (no absolute)

Question 5

What is mindfulness?

Answer 5

Paying attention in a particular way: on purpose, in the present moment, and non judgementally
Accept thoughts as just thoughts

Question 6

Dysfunctional attitudes and depression

Answer 6

Mood induction experiments can trigger dysfunctional attitudes in previously depressed people - quick to fall back into depression

Question 7

Aims of mindfulness based cognitive therapy

Answer 7

• help people who have suffered from depression to learn skills to prevent relapse - recognise and disengage from self-perpetuating ruminative negative thoughts
• become more aware of bodily sensation, feelings and thoughts moment to moment
• develop a different way of relating to sensations, feelings and thoughts (mindful acceptance & acknowledgement of unwanted thoughts)

Question 8

MBCT procedure?

Answer 8

• didactic, instructional rather than group therapy
• relies on experiential learning
• each session involves practice of technique
• 8 session programme
• teach to continue after programme ends

Question 9

benefits of MB stress reduction

Answer 9

• reduced anxiety
• reduced contact with GP
• improved immune response
• improved sleep
• reduced anger, tension, depression
• improved physical conditions (chronic fatigue, psoriasis..)