KPSC Staff Nurse - 2016
Mental Health Nursing
Easy
Which of the following conditions is known to have the best response to Electro Convulsive Therapy (ECT)?
Appeared in: KPSC Staff Nurse - 2016
Explanation
- ECT is the fastest and most effective treatment for major depressive disorder, particularly when there is an acute risk of suicide, making it the best choice among the options.
- It is indicated when a rapid, definitive response is required, as antidepressant medications can take several weeks to become effective.
- ECT is highly effective for severe depression with psychotic features or catatonia, and for patients who have not tolerated or responded to medication trials.
- The rapid reduction in suicidal ideation is a key reason for its use in emergency psychiatric situations.
Why Other Options Were Wrong
- Option B: Simple schizophrenia is characterized by negative symptoms (e.g., apathy, avolition), which generally show a poor response to ECT. Antipsychotic medications are the primary treatment.
- Option C: Antipsychotic medications are the first-line treatment for paranoid schizophrenia. ECT is not the primary therapy and is only considered as an adjunct for specific, severe symptoms like catatonia or treatment-resistant positive symptoms.
- Option D: ECT is not a standard or first-line treatment for OCD. The primary treatments are SSRIs and Cognitive Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP).
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Indications for Electroconvulsive Therapy (ECT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses play a vital role in educating patients and families about ECT, dispelling common myths and misconceptions, and ensuring informed consent is properly obtained.
- Meticulous pre-procedure preparation and post-procedure monitoring by the nurse are critical for patient safety and managing common side effects like confusion and short-term memory loss.
- What if? If a severely depressed patient with suicidal ideation also has a recent myocardial infarction (heart attack)? This would be a relative contraindication. The risks of ECT (cardiac stress) would need to be carefully weighed against the benefits (preventing suicide) by a multidisciplinary team, and the procedure would require intensive cardiac monitoring if pursued.
How to Approach the Question
- First, identify the core of the question. It asks for the condition with the 'best response' to ECT, which requires you to know and rank the primary indications for this therapy.
- Recall the main uses of ECT. It is most strongly associated with severe mood disorders.
- Evaluate each option against your knowledge of ECT indications:
- Option A (Depression with suicidal tendency): This is a classic, textbook primary indication for ECT due to its rapid and effective action.
- Option B & C (Schizophrenia types): Recall that ECT is a secondary or adjunctive treatment for schizophrenia, used for specific symptoms (like catatonia) rather than the disorder itself.
- Option D (OCD): Remember that ECT is not a standard treatment for OCD; medication (SSRIs) and therapy (CBT/ERP) are the first-line choices.
Concept Tested & Keywords
- Concept Tested: Indications for Electroconvulsive Therapy (ECT)
- Stem keywords: Electro Convulsive Therapy, ECT, best response
- Lead-in keywords: best response
- Negative lead-in flag: false
Question ID
QNMYNQb33ZaeHNTOeBiVms
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2299-2301
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 140-142
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 11173-11175
Practise the full KPSC Staff Nurse - 2016
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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