Yudofsky S C
Am J Psychother. 1982 Jul;36(3):391-8. doi: 10.1176/appi.psychotherapy.1982.36.3.391.
This paper reviews the special indications for ECT. Included among these are delusional depression, affective illness which occurs in the geriatric population, depressions which are not responsive to pharmacologic intervention; depressed manic or schizophrenic patients who do not tolerate medication side effects; and drug-refractory Parkinson's disease. Technological advantages which have increased the safety of the procedure while reducing the side effects include: brief pulse electrical stimulation of the seizure, nondominant unilateral placement of electrodes, and simultaneous monitoring of EEG and EKG during the procedures. Finally, the five steps designed to address psychological issues as they relate to ECT are outlined and ECT is placed into the perspective of an overall therapeutic strategy in treating the patients.
本文综述了电休克治疗（ECT）的特殊适应证。其中包括妄想性抑郁、老年人群中发生的情感性疾病、对药物干预无反应的抑郁症；不能耐受药物副作用的抑郁躁狂或精神分裂症患者；以及药物难治性帕金森病。在提高治疗安全性同时减少副作用的技术优势包括：发作期的短脉冲电刺激、电极的非优势侧单侧放置以及治疗过程中脑电图（EEG）和心电图（EKG）的同步监测。最后，概述了针对与ECT相关的心理问题设计的五个步骤，并将ECT置于治疗患者的整体治疗策略背景中。
