Medicine / 7.Clinical medicine

Chugunov V.V., Kurilo V.A., Danilevska N.V.

Zaporizhzhya State Medical University Ministry of Healthcare of Ukraine

postictally suggestion as Way of preventing the recurrence of depression in patients treated with electroconvulsive therapy

Research actuality. Biological methods for the treatment of depression, which include electroconvulsive therapy, have long established themselves as etiopathogenetic – affecting influential components of the disease and is able to achieve prolonged remissions even in cases of pharmacoresistant [1, 3].

The modern technique of electroconvulsive therapy with anesthesia and muscle relaxation allows in short time to achieve the significant improvements in mood without the classic electroconvulsive therapy side effects [3].

Electroconvulsive therapy has a proven antidepressant effect. It helps to improve the mood of patients even after the first sessions. But in some cases, relapse of the disease. It is associated with the pathogenesis of depression. Іn the genesis endoreactive depression in addition to the endogenous depressed mood, plays significant role in the cognitive component, the unpleasant thoughts and feelings of psychotrauma genesis, which arose in response to the transferred patients psychological trauma. This forced us to find ways of preventing the recurrence of depression in patients treated with electroconvulsive therapy.

The aim of research was to determine the postictally suggestion as Way of preventing the recurrence of depression in patients treated with electroconvulsive therapy

Materials research. We formed two groups of patients. Patients of the first group (n=4) were treated by electroconvulsive therapy without combination with other therapies. Patients of the second group (n=6) were treated in compliance with the combined method we have developed a combination of electroconvulsive therapy and postictally suggestion.

Method of research: psychopathological, psychodiagnostic, anamnestic. For quantification of the results used: Hamilton Rating Scale for Depression (HDRS-HAM-D, M.Hamilton, 1960); Association test (F.E.Rybakov, 1910) [2, 4].

Used equipment: Apparatus for electroconvulsive therapy "NIVIQURE" (Niviqure Meditech Private Limited. India. Code UCGFEA: 9018 90 75 00. Certificate on registration № 8222/2008, 15.10.2008).

In the purpose of preventing the recurrence of depression, we have developed a combined technique, combined electroconvulsive therapy and postictally suggestion.

Manipulation aimed at mitigating painful traumatic experiences in patients with depression who were treated by electroconvulsive therapy method consisted of two stages observed. The first stage is one minute before application of anesthesia, patients were asked to focus on painful experiences.

The second stage – in the first minutes after the release of patients from anesthesia, patients were susceptible to hypnotic suggestion designed with therapeutic formulas aimed at correction of traumatic experiences.

As a result of the developed technique, we have achieved two therapeutic effects:

1. due to electroconvulsive therapy the mood of patients noticeably improved from the first session according to the test, Hamilton Rating Scale for Depression total score was reduced from 23,4±0,75 to 5,0±0,52 points (pic. 1).

Pic. 1. The results of the study on a Hamilton Rating Scale for Depression.

2. due to additions of electroconvulsive therapy sessions of postictally hypnotherapy, effectively neutralised by traumatic experiences, which allowed to avoid the relapse of the disease – thus, according to the associative test was noted the elimination of the previously dominant in the cognitive sphere of patients negative experiences (pic.2).

Pic. 2. The results of the study on a Association test.

All patients who followed a course of therapy developed by our method indicated a full recovery; during one year of follow-up after therapy, disease recurrence was not.

References.

1. Roman A., Kreiner G., Nalepa I. Macrophages and depression – a misalliance or well-arranged marriage? Pharmacol. Rep., 2013, no.65(6), pp.1663 – 1672.

2. Hamilton M. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 1960, no.23, рр.56 – 62.

3. Nelson A. I. Electroconvulsive therapy in psychiatry, narcology and neurology. Moscow: BINOM. Knowledge laboratory, 2005, 368 p. (Rus.).

4. Rybakov F. E. Atlas for the experimental-psychological research of personality with a detailed description and explanation of the tables. Saint Petersburg: KARO, 2008, 120 p. (Rus.).