Abstract
A 34-year-old schizophrenic committed suicide after his fourth unilateral electroconvulsive treatment. He previously responded successfully to seven bilateral treatments. The authors hypothesize that unilateral ECT may post a greater risk than bilateral ECT for the delusional suicidal patient. The rationale underlying this hypothesis states that the greater temporary disruption in cognition and memory associated with bilateral ECT is actually desirable in suicidal patients although it is an unwanted side effect in nonsuicidal patients. Since energy and mood often improve before delusions, bilateral ECT may neutralize delusions during the time of maximum suicidal risk as patients begin to improve.
Similar content being viewed by others
References
Avery D, Winokur G.: Mortality in depressed patients treated with electroconvulsive therapy and antidepressants.Arch Gen Psychiat 331023–1037, 1976.
Electroconvulsive therapy.American Psychiatric Association Task Force Report 14 22, 1978.
Squire LR, Slater PC: Bilateral and unilateral ECT: Effects on verbal and nonverbal memory.Am J Psychiatry 1351316–1320, 1978.
Squire LR, Slater PC: Bilateral and unilateral ECT: Effects on verbal and nonverbal memory.Am J Psychiat 1351316–1320, 1978.
D'Elia G, Raotma H: Is unilateral ECT less effective than bilateral ECT?Br J Psychiat 12683–89, 1975.
Abrams R, Taylor MA: Diencephalic stimulation and the effects of ECT in endogenous depression.Br J Psychiatry 129482–485, 1976.
Weiner RD: The psychiatric use of electrically induced seizures.Am J Psychiat 1361515, 1979.
Wetzel RD: Hopelessness, depression and suicide intent.Arch Gen Psychiatr 331069–1073, 1976.
Noyes AP, Kolb LC:Modern Clinical Psychiatry. Philadelphia, W.B. Saunders, 1963, p. 78.
Detre TP, Jarecki HG:Modern Psychiatric Treatment. Philadelphia, J.P. Lippincott, 1971, pp. 54–59.
Squire LR: ECT and memory loss.Am J Psychiat 134997–1001, 1977.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gambill, J.D., McLean, P.E. B. Suicide after unilateral ect in a patient previously responsive to bilateral ect. Psych Quart 55, 279–281 (1983). https://doi.org/10.1007/BF01074556
Issue Date:
DOI: https://doi.org/10.1007/BF01074556