Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy

Pichai Ittasakul,1 Phathamon Jarernrat,1 Phern-Chern Tor2 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Mood and Anxiety, Institute of Mental Health, SingaporeCorrespondence: Pichai IttasakulDepartment of Psychiatry, Facul...

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Autores principales: Ittasakul P, Jarernrat P, Tor PC
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Lenguaje:EN
Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:ef60e17d6e4a42d1ba6b02076ae673c22021-12-02T12:14:52ZPrevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy1178-2021https://doaj.org/article/ef60e17d6e4a42d1ba6b02076ae673c22021-02-01T00:00:00Zhttps://www.dovepress.com/prevalence-and-predictors-of-postictal-confusion-after-electroconvulsi-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Pichai Ittasakul,1 Phathamon Jarernrat,1 Phern-Chern Tor2 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Mood and Anxiety, Institute of Mental Health, SingaporeCorrespondence: Pichai IttasakulDepartment of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, ThailandTel +662-2011478Fax +662-200-3277Email pichai.itt@mahidol.eduObjective: To investigate the prevalence and predictors of postictal confusion (PIC) in patients who received electroconvulsive therapy (ECT).Methods: We conducted chart reviews for 79 patients who were receiving inpatient ECT. Subjects with PIC were identified. PIC was defined by confusion, disorientation, motor restlessness, purposeless movement, and nonresponse to verbal commands following ECT within an hour, intravenous benzodiazepine was necessary to manage disturbed behavior. Multivariable logistic regression analysis was used to examine the association of PIC with demographic and clinical variables.Results: Prevalence of PIC was 36.7%. In 912 ECT sessions, the occurrence of PIC was 86 times. Patients with PIC (n = 29) had significant higher body mass index (BMI) (27 ± 6.6 kg/m2 vs 24.1 ± 5.2 kg/m2, t = − 2.22, df = 77, p = 0.029) than patients without PIC (n = 50). PIC associated with BMI (Pearson correlation = 0.25, p = 0.029). BMI was significant predictor of PIC after adjusting for other covariates (odds ratio = 0.91, 95% CI= 0.83– 0.99, p < 0.035).Conclusion: PIC was not uncommon in patients receiving ECT. BMI was an independent predictor of PIC. Psychiatrists should be aware of the risks of PIC in patients with high BMI receiving ECT.Keywords: electroconvulsive therapy; ECT, body mass index; BMI, Thai patients, agitation, postictal confusion; PICIttasakul PJarernrat PTor PCDove Medical Pressarticleectbody mass indexthai patientsagitationpostictal confusionNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 283-289 (2021)
institution DOAJ
collection DOAJ
language EN
topic ect
body mass index
thai patients
agitation
postictal confusion
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle ect
body mass index
thai patients
agitation
postictal confusion
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Ittasakul P
Jarernrat P
Tor PC
Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy
description Pichai Ittasakul,1 Phathamon Jarernrat,1 Phern-Chern Tor2 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Mood and Anxiety, Institute of Mental Health, SingaporeCorrespondence: Pichai IttasakulDepartment of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, ThailandTel +662-2011478Fax +662-200-3277Email pichai.itt@mahidol.eduObjective: To investigate the prevalence and predictors of postictal confusion (PIC) in patients who received electroconvulsive therapy (ECT).Methods: We conducted chart reviews for 79 patients who were receiving inpatient ECT. Subjects with PIC were identified. PIC was defined by confusion, disorientation, motor restlessness, purposeless movement, and nonresponse to verbal commands following ECT within an hour, intravenous benzodiazepine was necessary to manage disturbed behavior. Multivariable logistic regression analysis was used to examine the association of PIC with demographic and clinical variables.Results: Prevalence of PIC was 36.7%. In 912 ECT sessions, the occurrence of PIC was 86 times. Patients with PIC (n = 29) had significant higher body mass index (BMI) (27 ± 6.6 kg/m2 vs 24.1 ± 5.2 kg/m2, t = − 2.22, df = 77, p = 0.029) than patients without PIC (n = 50). PIC associated with BMI (Pearson correlation = 0.25, p = 0.029). BMI was significant predictor of PIC after adjusting for other covariates (odds ratio = 0.91, 95% CI= 0.83– 0.99, p < 0.035).Conclusion: PIC was not uncommon in patients receiving ECT. BMI was an independent predictor of PIC. Psychiatrists should be aware of the risks of PIC in patients with high BMI receiving ECT.Keywords: electroconvulsive therapy; ECT, body mass index; BMI, Thai patients, agitation, postictal confusion; PIC
format article
author Ittasakul P
Jarernrat P
Tor PC
author_facet Ittasakul P
Jarernrat P
Tor PC
author_sort Ittasakul P
title Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy
title_short Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy
title_full Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy
title_fullStr Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy
title_full_unstemmed Prevalence and Predictors of Postictal Confusion After Electroconvulsive Therapy
title_sort prevalence and predictors of postictal confusion after electroconvulsive therapy
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/ef60e17d6e4a42d1ba6b02076ae673c2
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