Outlining my research paper: Electroconvulsive Therapy

I am working on a research paper for my composition 2 class and had to pick a topic related to Health and Medicine. I stumbled around quite a few ideas and finally last night compiled an outline that I will turn in later today. I decided to write about electroconvulsive Therapy and if it works and is a legit practice. This is what I have come up with so far:

Electroconvulsive Therapy (ECT)

Is electroconvulsive therapy therapeutic for those who suffer from severe depression or mania?

1.       A. What is electroconvulsive therapy? It is previously known as electroshock. It is a well established, yet controversial, psychiatric treatment which involves electrically induced seizures on anesthetized patients to result in a therapeutic result.

B. Who receives electroconvulsive therapy?  Today it is most commonly used for the treatment of mania, catatonia, and severe major depression.

C. Electroconvulsive therapy was first introduced in the 1930’s. Use became more widespread between the 1940’s and 1950’s.

D. There is an estimated 1 million people undergoing electroconvulsive treatment each year.

E. ECT usually is administered by a course of 6-12 treatments, 2-3 times a week.

2.            A. There are three forms of application. Each application has extreme differences, adverse side effects, and positive outcomes. The three different applications include electrode placement, frequency of treatments, and the electrical waveform of the stimulus.

B. Along with ECT, medication is usually continued afterward and some patients even have continued ECT treatment.

3.            A. The American Psychiatric Association (APA) 2001 guidelines give the primary indications for ECT among patients with depression as a lack of response to, or intolerance of, antidepressant medications; a good response to previous ECT; and the need for a rapid and definitive response (e.g. because of Psychosis or a risk of suicide).

B. ECT is rarely used as a first-line treatment.

C. Informed consent is standard. Involuntary ECT is preformed uncommonly and is only done under extreme circumstances.

4.            A. 2003 NICE ECT guidelines reported that the use of ECT in patients suffering for Schizophrenia is not recommended and it is supported by meta-analytic evidence with no or little verses placebo.

B. A follow-up study of New York ECT patients, 2004, showed that in 65 years of ECT use, remission rates were only 30 to 47 percent and 64 percent of those patients relapsed within six months. Only after removing patients with co-morbid personality disorders or those suffering from schizoaffective disorders from the analysis did the remission rates peak to 60 to 70 percent.

C. The UK ECT Review group published a systematic review and meta-analysis that compared ECT to placebo and antidepressant drugs, finding that there was a larger effect for ECT versus placebo and antidepressant drugs.

5.  Adverse Effects

6. Effects on Memory

7. History

8. Public Perception

9.            A. My goal for researching ECT is to develop a larger understanding of a procedure that is involved in the field I hope to work in someday. I am currently in school and hope to obtain my Psychiatry degree by the end of my schooling. Researching ECT will broaden my understanding of some of the practices that are involved in the line of work that I look forward to.