ITS ONLY A INTRODUCTION NOT IN DETAIL

1. MISCELLANEOUS PSYCHIATRY

2. ECT
• DIRECT ECT
• MODIFIED ECT (INDIRECT ECT)

3. DIRECT ECT
• NO MUSCLE RELAXANTS
• INCREASED RISK OF THORACIC FRACTURES

4. MODIFIED ECT
• MUSCLE RELAXANTS AND ANAESTHETIC
AGENTS

5. ELECTRODE PLACEMENT
• BILATERAL
– MOST COMMONLY USED – BIFRONTOTEMPORAL
ELECTRODE PLACEMENT.
– OTHER
• BI FRONTAL ELECTRODE PLACEMENT
• UNILATERAL(RIGHT > LEFT)

6. MECHANISM OF ACTION
• INCREASE IN BRAIN DERIVED NEUROTROPHIC
, BDNF

7. INDICATIONS
• DEPRESSION WITH SUICIDAL RISK
• DEPRESSION WITH STUPOR
• DEPRESSION WITH PSYCHOTIC SYMPTOMS

8. • S/E OF MODIFIED ECT
• ANTEGRADE AMNESIA
• RETROGRADE AMNESIA
• RETROGRADE AMNESIA (RESOLVES BY
6MONTHS) > ANTEGRADE AMNESIA (
RESOLVES BY 6 HOURS)

9. ECT
• MAXIMUM ECT – 2 TIMES / WEEK
• MAXIMUM – 8 TIMES – IF NOT RESPOND –
ECT RESPONSE

10. • MANIA
– INTOLERABLE TO PHARMACOLOGICAL
MEDICATION

11. CONTRAINDICATIONS
• NO ABSOLUTE CONTRAINDICATIOONS

12. RELATIVE CONTRAINDICATIONS
• RAISED INTRACRANIAL TENSION
• RECENT MI
• SEVERE HYPERTENSION
• CEREBROVASCULAR DISEASE
• SEVERE PULMONARY DISEASE
• RETINAL DETACHMENT

13. COGNITIVE DEVELOPMENTAL STAGES
• SENSORIMOTOR
• STAGE OF PREOPRATIONAL THOUGHT
• STAGE OF CONCRETE OPERATION
• STAGE OF FORMAL OPERATION

14. SENSORIMOTOR CHANGE
• OBJECT PERMANENCE
• ANOTHER IMPORTANT DEVELOPMENT,AT
AROUND 18 MONTHS, SYMBOLISATION(START
DEVELOPING MENTAL SYMBOLS FOR OBJECT)

15. STAGE OF PREOPERATIONAL
THOUGHT(2-7 YEARS)
• IN THIS STAGE, BABIES ARE EGOCENTRIC
• INTUITIVE THOUGHT,WHICH MEANS
THINKING WITHOUT REASONING AND AN
INABILITY TO USE LOGICALITY

16. STAGE OF CONCRETE OPERATION(7-11
YEARS)
• OPERATIONAL THOUGHT DEVELOPMENT
• THERE IS REASONING
• TWO THINGS
• CONSERVATION
• REVERSIBILITY

17. • CONSERVATION

18. STAGE OF FORMAL OPERATION (11 –
END OF ADOLESCENSE)
• ABSTRACT THINKING
• EXTRACTING DEEPER MEANING AND DEDUCE
THE LARGER MEANING

19. PSYCHOSURGERIES
• DONE TO INDIVIDUAL WHO NOT RESPOND TO
ANY MEDICATION

20. • STEREOTACCTIC SUBCAUDATE TRACTOTOMY
• STEREOTACTIC LIMBIC LEUCOTOMY
• AMYGDALOTOMY