The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging (A Task Force Report of the American Psychiatric Association) / Edition 2

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Since the development of pharmacoconvulsive therapy in 1934 and of electroconvulsive therapy (ECT) in 1938, ECT has proven far more valuable than just the intervention of last resort. In comparison with psychotropic medications, we now know that ECT can act more effectively and more rapidly, with substantial clinical improvement that is often seen after only a few treatments. This is especially true for severely ill patients -- those with severe major depression with psychotic features, acute mania with psychotic features, or catatonia. For patients who are physically debilitated, elderly, or pregnant, ECT is also safer than psychotropic medications.

The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in 1990 as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally. Since then, advances in the use of this technically demanding treatment prompted the APA to mandate a second edition.

The updated format of this second edition presents background information followed by a summary of applicable recommendations for each chapter. This close integration of the recommendations with their justifications makes the material easy to read, understand, and use. To further enhance usability, recommendations critical to the safe, effective delivery of treatment are marked with the designation "should" to distinguish them from recommendations that are advisable but nonessential (with the designations "encouraged," "suggested," "considered").

The updated content of this second edition, which spans indication for use of ECT, patient evaluation, side effects, concurrent medications, consent procedures (with sample consent forms and patient information booklet), staffing, treatment administration, monitoring of outcome, management of patients following ECT, and documentation, as well as education, and clinical privileging.

This volume reflects not only the wide expertise of its contributors, but also involved solicitation of input from a variety of other sources, including applicable medical professional organizations, individual experts in relevant fields, regulatory bodies, and major lay mental health organizations. In addition, the bibliography of this second edition is based upon an exhaustive search of the clinical ECT literature over the past decade and contains more than four times the original number of citations.

Complemented by extensive annotations and useful appendixes, this remarkably comprehensive yet practical overview will prove an invaluable resource for practitioners and trainees in psychiatry and related disciplines.

American Psychiatric Publishing

Recommendations for clinical practice/education, training & privileging in ECT/rationales for recommendations.

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Editorial Reviews

Doody's Review Service
Reviewer: Nishad J. Nadkarni, MD (Rush University Medical Center)
Description: Based on the APA Taskforce on Electroconvulsive Therapy (ECT), this is a guide to the most current recommendations for practitioners of this treatment modality.
Purpose: ECT is often seen by practitioners as the treatment of "last resort." Through a systematic and cogent presentation of work done by the APA Taskforce, the authors attempt to present guidelines to demystify this procedure.
Audience: This book is primarily targeted at practitioners of ECT as well as psychiatric trainees seeking credentialing in this area. However, it should be a part of all psychiatrists' libraries as a current reference on this treatment modality.
Features: Supported by a comprehensive and pertinent index, this work offers an exhaustive set of current recommendations regarding the indications, contraindications, and actual practice of ECT. It covers all aspects of the procedure, including a long look at medicolegal and patient issues. The limited number of line diagrams are helpful, though schematic representations of EEG tracings are not adequately represented.
Assessment: Any practitioner of ECT must own this book, and be thoroughly familiar with its contents. As an outgrowth of work done by the APA Taskforce on ECT, it presents "standard of practice" recommendations on this procedure. In its second edition, it is highly current. Even psychiatrists who do not personally conduct ECT treatments will find it useful as a reference.
The Association called for a second edition of their 1990 guidelines in order to incorporate subsequent research and experience into the recommendations. The committee, upgraded from a task force for the job, took input from a large number of professional organizations, individual specialists in related areas, regulatory bodies, and major law mental health organizations. They want the recommendations to be clinically useful as well as scientifically, ethically, and legally sound. Annotation c. Book News, Inc., Portland, OR (

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780890422069
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 1/28/2000
  • Edition description: Second Edition
  • Edition number: 2
  • Pages: 368
  • Sales rank: 587,978
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.00 (d)

Table of Contents

Introduction. Indications for ECT use. Medical conditions associated with substantial risk. Use of ECT in special populations. Adverse effects. Pre-ECT evaluation. Use of medications during the ECT course. Consent for ECT. Staffing. Location, equipment, and supplies. Treatment procedures. Evaluation of outcome. Treatment following completion of the index ECT course. Documentation. Education and training in ECT. Privilege in ECT. Appendix A: Individuals and groups providing input to the document revision process. Appendix B: Sample ECT consent documents. Index.

American Psychiatric Publishing

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