Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.
Asian J Psychiatr. 2023 Nov;89:103747. doi: 10.1016/j.ajp.2023.103747. Epub 2023 Aug 19.
The paper describes the introduction, and early use of chemically and electrically induced convulsive therapies, at the Mysore Government Mental Hospital (MGMH), now the National Institute of Mental Health and Neuro Sciences, Bangalore, India. Cardiazol and ammonium chloride were used at MGMH before the introduction of electroconvulsive therapy (ECT). The study examines the early history, clinical correlates and outcome of convulsive therapies and attempts to contextualize how local conditions influenced implementation.
Three sets of archival case-records from 1938 to 1948, each of a period of 9 months following the implementation of a particular mode of convulsive therapy were reviewed.
During the examined timeframe, 40 patients received cardiazol, 95 ammonium chloride and 50 unmodified ECT. Schizophrenia was the commonest clinical indication for convulsive therapy across all modalities of treatment. When outcomes were examined, 45%, 48.4% and 62% of patients were clinically reported to have been either cured/improved after receiving cardiazol, ammonium chloride and ECT respectively. Those receiving cardiazol had a high mortality of 22.5%, compared to 3.1% for ammonium chloride and 4% with ECT.
Convulsive therapies were one of the first somatic psychiatric treatments, introduced around 1930s and 1940s all over the world, including in India. Our archival records suggest that many international ideas about somatic treatments were quickly adopted in India. Electroconvulsive therapy and other novel neuromodulatory interventions continue to be used and actively researched in India.
本文描述了化学诱导和电诱导惊厥疗法在印度班加罗尔的国家心理健康和神经科学研究所（NIMHANS）前身——迈索尔政府精神病院（MGMH）的引入和早期应用。在引入电抽搐疗法（ECT）之前，MGMH 使用了卡地唑和氯化铵。本研究考察了惊厥疗法的早期历史、临床相关性和结果，并试图将当地条件如何影响实施情况纳入考虑。
我们回顾了 1938 年至 1948 年期间的三组档案病历，每组均为实施特定惊厥疗法后 9 个月的时间段。
在研究期间，40 名患者接受了卡地唑、95 名患者接受了氯化铵、50 名患者接受了未经改良的 ECT。精神分裂症是所有治疗模式中最常见的惊厥治疗临床指征。当检查结果时，分别有 45%、48.4%和 62%的接受卡地唑、氯化铵和 ECT 的患者被临床报告为治愈/改善。接受卡地唑治疗的患者死亡率高达 22.5%，而氯化铵组为 3.1%，ECT 组为 4%。
惊厥疗法是世界范围内引入的第一批躯体精神科治疗方法之一，包括在印度。我们的档案记录表明，许多关于躯体治疗的国际理念在印度很快得到了采用。电抽搐疗法和其他新的神经调节干预措施在印度继续得到使用和积极研究。
