African Journal of Psychiatry

The AJOL site is currently undergoing a major upgrade, and there will temporarily be some restrictions to the available functionality.
-- Users will not be able to register or log in during this period.
-- Full text (PDF) downloads of Open Access journal articles will be available as always.
-- Full text (PDF) downloads of subscription based journal articles will NOT be available
We apologise for any inconvenience caused. Please check back soon, as we will revert to usual policy as soon as possible.

Electroconvulsive therapy in single manic episodes: a case series

H Mohammadbeigi, S Alizadegan, M Barekatain


Objective: To evaluate the effectiveness of electroconvulsive therapy in the treatment of Bipolar I Disorder patients with a single manic episode. Method: In a retrospective study, we reviewed medical records of inpatients who had been admitted to treat a single manic episode of Bipolar I Disorder at Noor University Hospital, Isfahan, Iran between September 2004 and December 2008. Results: Out of a total of 275 single episode manic patients, 39 underwent ECT. Male/ female ratios were 19/20 (48.7% vs. 51.3%) for the ECT series and 137/99 (58% vs. 42%) for the exclusive pharmacological treatment series (p>0.05). Mean age of patients in the ECT series (23.64 ± 8.00) was significantly lower than the pharmacological treatment series (27.65± 11.30, p= 0.008). The mean length of stay (LOSs) for the ECT series (20.0± 7.90) was significantly higher than the other group (14.63± 9.84, p =0.001). The mean time to first administered ECT (tECT) was 4.35 ± 3.79. There was no significant difference between the mean LOSs of the pharmacologic treatment series and the mean “LOSs minus tECT“(LOS-tECT) variable (16.57±8.43) in the ECT series (p>0.05). The mean duration from the onset of the symptoms to time of admission was 19.22± 3.53 for the ECT series. Catatonia was the indication for application of ECT in one patient (2.6%), while 25 (64.10%) received ECT because of aggressive behavior. The proportion of patients administered chemical and physical restraints before ECT (77%) significantly dropped (7.7%) after ECT administration (p<0.001). Conclusion: ECT is an effective, safe, and probably underused treatment method for single episode manic patients. Reducing the time until commencement of ECT should be considered, even in a single manic episode.

Key words: Electroconvulsive therapy; Bipolar I disorder; Single manic episode
AJOL African Journals Online