The use of electroconvulsive therapy in a cohort of forensic psychiatric patients with schizophrenia

International Conference on Forensic Research & Technology

October 15-17, 2012 DoubleTree by Hilton Chicago-Northshore, USA

Diana Kristensen

Scientific Tracks Abstracts: J Forensic Res

Abstract :

In Denmark, over 2500 people are in psychiatric treatment in forensic mental health services at any one time, most suffering from schizophrenia. Many of them have illnesses that are resistant to medication. There is evidence of the effectiveness of electroconvulsive therapy (ECT) for schizophrenia, but not explicitly for this complex forensic group. Aims: The aim of this study was to describe the outcome of using ECT as augmentation therapy in a cohort of forensic psychiatric patients with schizophrenia who were failing to respond to antipsychotic medication. Methods: In one university-based psychiatric clinic, data were extracted from the medical records of all patients treated with ECT during a 6-year period. Fifty-nine of these patients were diagnosed within the schizophrenia spectrum and eight were in specialist forensic hospital services. Results: The mean duration of illness for the forensic cohort was 16 years (range 3?33 years), with the index episode having lasted a mean of 34 months (3 weeks to 8 years) in spite of treatment with at least two antipsychotic drugs. Psychotic symptoms were accompanied by seriously assaultive behavior in all cases. All but one of these patients had an excellent or good symptomatic and behavioral response to ECT. Half (four) went on to maintenance ECT. No adverse effects were documented. Conclusion: ECT is rarely used in specialist secure services, but should not be forgotten as a treatment that may enable medication-resistant, assaultive psychotic patients to progress safely out to the community.

Biography :

Diana Kristensen, M.D. is a specialist in Psychiatry at the Psychiatric Centre of Copenhagen, the capital city of Denmark. She has performed research within the field of cognitive impairment following anesthesia as a member of the ISPOCDII study group. Her latest field of research is the use of Electroconvulsive therapy for Schizophrenia, Metabolic Syndrome and arrhythmias following the use of psychotropic drug. She was a section Editor for the 2011 theme number ?treatment of schizophrenia? in Drug Discoveries Today, therapeutic strategies, and she is a member of the NACT board.