Academic journal article Hong Kong Journal of Psychiatry

The ECT Handbook (Second Edition)

Academic journal article Hong Kong Journal of Psychiatry

The ECT Handbook (Second Edition)

Article excerpt

The ECT Handbook (Second Edition) Editor: Allan IF Scott. Gaskell (Royal College of Psychiatrists), London, 2005. US$73.60; pp 243; ISBN: 190467 1225

Electroconvulsive therapy (ECT) has been used to treat various psychiatric conditions, including depressive illness, mania, schizophrenia and catatonia. The technique has become an important treatment in contemporary psychiatric practice. However, there are concerns about its efficacy, safety and mode of action. This handbook may not provide a clear solution or any definitive answer on the place in therapy of ECT, but it does provide timely materials and recommendations, and is written in the light of recent guidelines.

The main text is divided into 4 parts: clinical guidelines; psychotropic drug treatment and ECT; the administration of ECT; and the law and consent. Part 1 begins with "the place of ECT in contemporary psychiatric practice", where the existing recommendations on the role of ECT in the treatment of depressive disorder, mania, schizophrenia and catatonia can be found. These are considered and discussed in detail in the subsequent chapters. In the treatment of depression, the circumstances under which ECT should be used as a first- or second-line treatment are clearly delineated. In schizophrenia, the evidence to support the use of ECT as a maintenance treatment is examined critically.

The chapter on the law and consent to treatment reflects recent concern on legal aspects of informed consents and the rights of people incapacitated by mental disorder. The statutory provisions of the Mental Health Act 1983 are not directly applicable to Hong Kong. However, the common law position and reasoning, such as the 'Bournewood' judgement, the concept of 'necessity' and the assessment of mental capacity are relevant to our clinical practices. The discussion on the law and consent to treatment in the UK can be very useful material for trainee psychiatrists preparing for professional examination in the UK. …

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