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Biomedical subjects

S H Bailine

Publications and source records attributed to S H Bailine.

8 recordsLinked to original sources
PubMed2001

ECT remission rates in psychotic versus nonpsychotic depressed patients: a report from CORE.

OBJECTIVE: To compare the relative efficacy of electroconvulsive therapy (ECT) in psychotic and nonpsychotic patients with unipolar major depression. METHODS: The outcome of an acute ECT course in 253 patients with nonpsychotic (n = 176) and psychotic (n = 77) unipolar major depression was assessed in the first phase of an ongoing National Institute of Mental Health-supported four-hospital collaborative study of continuation treatments after successful ECT courses. ECT was administered with bilateral electrode placement at 50% above the titrated seizure threshold. The remission criteria were rigorous: a score <or=10 on the 24-item Hamilton Rating Scale for Depression (HRSD) after 2 consecutive treatments, and a decrease of at least 60% from baseline. RESULTS: The overall remission rate was 87% for study completers. Among these, patients with psychotic depression had a remission rate of 95% and those with nonpsychotic depression, 83%. Improvement in symptomatology, measured by the HRSD, was more robust and appeared sooner in the psychotic patients compared with the nonpsychotic patients. CONCLUSION: Bilateral ECT is effective in relieving severe major depression. Remission rates are higher and occur earlier in psychotic depressed patients than in nonpsychotic depressed patients. These data support the argument that psychotic depression is a distinguishable nosological entity that warrants separate treatment algorithms.

Adult↗
PubMed2000

Comparison of bifrontal and bitemporal ECT for major depression.

OBJECTIVE: The authors compared the clinical and cognitive effects of bifrontal electrode placement with standard bitemporal electrode placement in the treatment of patients with major depression. METHOD: Forty-eight patients with unipolar or bipolar depression were treated with a course of bifrontal or bitemporal ECT. The Hamilton Rating Scale for Depression and the standardized Mini-Mental State were administered at baseline and repeated during the course of treatment. RESULTS: Forty-seven of the 48 patients who completed the course of treatment met remission criteria by the 12th treatment. There were no differences between the patients given bifrontal ECT and those given bitemporal ECT in the number of treatments required to reach remission criteria. The standardized Mini-Mental State scores of the patients given bitemporal ECT worsened more after treatment than did those of the patients given bifrontal ECT. CONCLUSIONS: Bifrontal electrode placement was as efficacious as bitemporal placement and resulted in less cognitive impairment. A study of the two placements with more cognitive measures is indicated.

Bipolar Disorder↗
PubMed1994

Flumazenil reversal of benzodiazepine-induced sedation for a patient with severe pre-ECT anxiety.

We describe various measures to reduce severe anxiety that interfered with much-needed maintenance electroconvulsive therapy in a 32-year-old man. Treatment with ketamine met with moderate success, and then large doses of lorazepam and midazalam were used. The potential anticonvulsant effect of these drugs was successfully reversed by the administration of intravenous flumazenil just prior to the treatments.

Adult↗
PubMed1982

Opening the door on a locked psychiatric unit.

A therapeutic milieu on acute locked psychiatric units is difficult to establish and maintain. The stigma of being on a locked unit and the absence of a sufficiently compelling goal around which patients can mobilize as a group are two factors that contribute to this difficulty. By opening the door under specific conditions, we were able to affect both these factors significantly. In this article, we describe the issue of feasibility, the technical devices employed, and seven months' experience with this system.

Hospital Bed Capacity, 500 and over↗
PubMed1977

Mini-groups: maximizing the therapeutic milieu on an acute psychiatric unit.

The authors have found small groups (called mini-groups) an effective way to work with patients who are too regressed or disturbed to benefit from individual psychotherapy and who find larger groups overwhelming and confusing. Mini-groups were formed in 1974 on a 20-bed acute inpatient service of a private psychiatric hospital, where traditional treatment approaches have been altered because of a more disturbed patient population and a shorter length of stay. A high staff-to-patient ratio, sometimes almost one to one, lends stability to the groups.

Hospitals, Psychiatric↗