Indication of ECT?

Appeared in: NIMHANS Nursing Officer - 2019

Explanation

Depression, specifically Major Depressive Disorder, is the most common and well-established indication for ECT.
ECT is considered a first-line treatment for severe, life-threatening depression, especially when accompanied by psychosis, catatonia, or acute suicidal intent, due to its rapid and high efficacy.
It is also highly effective for patients with depression who have not responded to or cannot tolerate antidepressant medications.

Why Other Options Were Wrong

Option A: While ECT is used for schizophrenia, it is not a primary or general indication. It is reserved for specific situations, such as acute exacerbations with severe positive symptoms or catatonia.
Option C: Delirium is an acute confusional state. It is generally considered a contraindication for ECT, as the procedure can worsen the confusion. The priority is to find and treat the underlying cause of the delirium.
Option D: This option is incorrect because a valid indication, Depression, is listed among the choices.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indications for Electroconvulsive Therapy (ECT) as background academic context rather than a clinical decision trigger.
Nurses are central to the ECT process, responsible for patient education, ensuring informed consent is obtained, pre-procedure preparation, and post-procedure monitoring and care.
A key nursing role is to manage patient and family anxiety by providing clear information about the procedure, its purpose, and what to expect, thereby demystifying a treatment that is often misunderstood.
Post-ECT, nurses must vigilantly monitor for potential side effects such as headache, nausea, muscle soreness, and transient memory loss, providing comfort measures and reorienting the patient as they recover from anesthesia.

How to Approach the Question

First, identify the core of the question, which is asking for a valid reason ('indication') to use Electroconvulsive Therapy (ECT).
Access your knowledge base about ECT. Recall the main psychiatric conditions it is used to treat.
Evaluate each option against this knowledge. 'Depression' is the most classic and primary indication for ECT.
Consider the other options. 'Schizophrenia' is a less common, more specific indication. 'Delirium' is a contraindication.
Based on this analysis, 'Depression' is the strongest and most accurate answer among the choices.

Concept Tested & Keywords

Concept Tested: Indications for Electroconvulsive Therapy (ECT)
Stem keywords: Indication, ECT
Lead-in keywords: BEST, MOST RELEVANT CLUE

Question ID

Qeb7zRt_uk-_Rp_mW5-GUx

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 2299-2301, 2300-2302

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 14073-14075

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