The indications are:
①Severe excitement and restlessness, impulsivity, injury and damage to people who need to control the mental symptoms as soon as possible;
②Severe depression, strong self-accusation, self-injury, suicidal behavior;
③Refusal of food, disobedience and nervous stiffness;
④Effective medication or intolerable to the drug. The presence of somatic or psychotic symptoms, as well as previous efficacy with ECT, appeared to be predictors of good outcome.
Before performing electroconvulsive therapy, it is important to do an exhaustive physical and neurological examination, such as chest X-ray, electrocardiogram, electroencephalogram, etc., to exclude brain disorders, to know the indications and contraindications, and to know the correct operation procedures. Electroconvulsive side effects are far fewer than those of antipsychotics, and the effect is quick. Do not generate fear. The kind of legend psychiatric hospitals to patients in the electric chair or psychiatrists with electric rods on the body of the statement, this is pure nonsense.
Electroconvulsive therapy is an effective method of treating mental illness. However, it is often thought to have a large side effect and there is a fear of damage to the brain, which is not the case.
When doing electric convulsion therapy, the electricity is 80-120V, under which the electric current passes directly through the human brain, resulting in generalized convulsions, loss of consciousness and no pain. At the end of the treatment, a small number of patients will have a headache, nausea and vomiting, minor cases do not have to deal with, serious cases can be relieved by symptomatic treatment. There are a small number of patients can appear blurred consciousness, slow reaction, which depends on the number of treatments and the length of the interval, generally 7 to 10 days gradually disappear. According to the data, electroconvulsive therapy can cause EEG changes, resulting in memory loss, but this situation lasts for a short time. It is generally accepted that normalization occurs within 1 month after electroconvulsive therapy. For depressed psychiatric patients with serious suicidal behavior, it takes 2 to 3 weeks to get the best results after drug treatment, such as the use of electroconvulsive therapy can be effective within a week. Foreign studies have proved that the electric convulsive therapy for more than 100 cases, and no obvious brain function effects, now a course of only 8 to 12 times, according to the analysis of electric convulsive therapy for 10,000 times, no life-threatening comorbidities occurred. Therefore, it can be said that electroconvulsive therapy is a safe and effective treatment.
Steps
In ECT, the use of electrical stimulation on the patient's head can induce grand mal seizures. Today, ECT under anesthesia is recommended to reduce the risk of side effects (e.g., fractures) and to increase its acceptability. Patients are anesthetized with fast-acting hypnotics and muscle relaxants prior to electroconvulsive therapy. Treatments are usually given 3 times a week, as an outpatient and as an inpatient, for a total **** of 6-12 treatments.
Pre-treatment formalities
Before treatment begins, the clinician must explain the psychological and medical issues, and that the mere mention of electroconvulsive therapy often triggers severe anxiety in patients and families. They must be educated about the benefits as well as the adverse effects of electroconvulsive and other treatments, and the risks of inappropriately treating severe depressive episodes. When the clinician feels that the patient and family appropriately understand the procedure, the patient and family or guardian should sign an informed consent form. The pretreatment evaluation should include a complete anesthetic history, physical examination, electrocardiogram, and possible laboratory tests to rule out electrolyte disturbances, cardiopulmonary, or neurologic risk factors.
SIDE EFFECTS
A common side effect associated with ECT is transient clouding of therapeutic consciousness and memory loss. Although memory impairment is almost conclusive during the course of treatment, a 6-month follow-up suggests that almost all patients return to their original level of cognition; some patients complain of persistent memory difficulties, but unilateral use of electrical stimulation of the nondominant cerebral hemispheres and replacement of sinusoidal-wave-current apparatus with apparatus that produces positive square-wave currents reduces the severity of the risk of memory impairment.
The medical term was later used to describe the treatment of inflation, the "aftermath" of the economic crisis. The basic intention of this economic prescription is to adopt a strictly tight financial and monetary policy, supplemented by means of compression of consumption, to forcibly close the gap between aggregate supply and aggregate demand, so as to achieve the purpose of curbing inflation in a short period of time. Due to the strong impact of the above economic measures, the social economy will be greatly shocked, or even in a "state of shock", so there is a medical analogy of "shock therapy". It was later cited as an economic term to describe a set of radical anti-economic crisis measures and an economic transformation approach that accomplishes everything in one go. The basic intention of this economic prescription is to adopt a strictly tight financial and monetary policy, supplemented by means of compression of consumption, in order to forcibly close the gap between aggregate supply and aggregate demand, and to achieve the purpose of curbing inflation in a short period of time. Due to the strong impact of the above economic measures, the social economy will be greatly shocked, and even in a "state of shock", so there is a medical analogy of "shock therapy".
In the mid-1980s, a young American economist, Jeffrey Sachs, introduced shock therapy into the economic field, and in the mid-1980s it began to be practiced in a number of countries in South America with great success. In Bolivia, a serious economic crisis broke out, with inflation as high as 24,000% and negative economic growth of 12%, leading to a lack of livelihood and political instability. Sachs was recruited in the face of danger, and offered the country a master plan: abandon expansionary economic policies, tighten the monetary and fiscal, liberalization of prices, the implementation of free trade, speed up the pace of privatization, and give full play to the role of the market mechanism. The above approach was a departure from the norm, and in the short term it caused a sharp economic shock, as if the patient had gone into a state of shock, but with the restoration of a balance between supply and demand in the market, the economy returned to normal. Two years later, Bolivia's inflation rate had fallen to 15 percent, GDP had grown by 21 percent, and foreign exchange reserves had increased more than 20-fold. Sachs's anti-crisis measures were a huge success, and shock therapy became world famous.
After the dramatic changes in the Soviet Union and Eastern Europe, the countries in this region immediately began to implement the transition from the original public ownership-based planned economic system to a private ownership-based market economic system. Thus, under the recommendation of the Western international financial organizations, most of the Eastern European countries, represented by Russia and Poland, adopted this radical approach. (A few countries, such as Hungary, adopted a gradual approach to transition.) However, they have failed at great cost.
The most familiar form of "shock therapy" is:
The Soviet Union collapsed at the end of 1991, and the Russian Federation became independent, inheriting much of the former Soviet Union's wealth. The rich heritage of Boris Yeltsin happy, but the poor family is difficult to be, a large number of half-dead enterprises, plus 1 trillion rubles of domestic debt and 120 billion U.S. dollars in foreign debt, but also let the new president sleepless nights, sitting and lying down. As the former Soviet **** opposition, Yeltsin believes that the reforms since the 1950s, piecemeal, tinkering, in vain, the Soviet Union's future. Painfully, Russia to avoid repeating the mistakes of the past, revitalize the great powers, can no longer be a small-footed old lady, should be bold, profound changes. At this time, the 35-year-old Heydar cast his mind, in the Sachs point of view, concocted a set of radical economic reform program, Yeltsin, "the eye of the beholder", promoted to prime minister of the government, the beginning of 1992, a shock therapy as a model of reform, in the Russian Federation, a comprehensive rollout.
Shock therapy is the main event, but also the first move is to liberalize prices. The Russian government mandated that, as of January 2, 1992, 90 percent of consumer prices and 80 percent of prices for means of production be liberalized. At the same time, restrictions on income growth were lifted, public salaries were raised by 90 percent, pensioners' benefits were raised to 900 rubles per month, and family allowances and unemployment benefits were also increased. In the first three months of price liberalization, the results seemed to be immediate and obvious. Long shopping lines disappeared, the shelves are full of goods, accustomed to long queues of ticket supply Russians, as if to see the benefits of reform. But not long after, prices like a kite with broken strings rocketed, by April, the price of consumer goods than in December 1991 rose 65 times. The government wanted to suppress prices through state-run stores, but it did not want black market traders, in collusion with state-run store employees, to resell the goods at exorbitant profits, so the government's plans fell through, and the market order became a mess. Because of fuel, raw material prices premature liberalization, enterprise production costs increased suddenly, to June, wholesale prices of industrial products rose 14 times, so high prices to buyers are afraid, the consumer market continues to slump, demand is not strong in turn inhibit the supply, enterprises have compressed production, market supply and demand has entered a dead cycle.
To this, the Russian government seems to have been prepared, the second move of shock therapy, financial and monetary "double tight" policy and price reform almost synchronized. Fiscal austerity is mainly open source, increase revenue and expenditure. Tax incentives were abolished, and all commodities were subject to a 28% value-added tax (VAT), while consumption tax on imported goods was increased. In tandem with the revenue-raising measures, the government cut public **** investment, military and office expenses, integrated off-budget funds into the federal budget, and restricted local governments from using bank loans to cover deficits. Tight monetary policies, including raising the central bank's lending rate, establishing a reserve requirement system, and implementing loan-limit management, were used to control the flow of money and curb inflation at the source. However, this time the government miscalculated again. As a result of the heavy tax burden, enterprise production shrank further, the number of unemployed people surged, and the government had to increase relief subsidies and direct investment, and the fiscal deficit rose rather than fell. The tightening of credit caused a serious shortage of enterprise liquidity, and enterprises defaulted on each other's debts, making the triangular debt increasingly serious. The government was forced to loosen its purse strings, issuing an additional 18 trillion rubles of currency in 1992, 20 times the amount issued in 1991. The fiscal and monetary austerity policy was aborted amid the roar of the money printing presses.
The third move in shock therapy was the massive introduction of privatization. According to Gaidar, the main reason for the perilous reforms and crises is that the state-owned enterprises are not market players, the competition mechanism does not work, and the price reforms are like building a tower in the sand, which will collapse as soon as it encounters the wind and the grass blows. In order to speed up the privatization process, the government initially took the approach of free gifts. The relevant experts assessed that Russia's state-owned property is worth 15 trillion rubles, just as the population is 1.5 billion, before the property is everyone's, and now divided into individuals, but also to the child, everyone has a share. So each Russian received a 10,000 ruble privatization securities, can be certified free to buy shares. However, by the time privatization was officially launched, it was already October 1992, and the time had changed, and the 10,000 rubles at that time were only enough to buy a pair of high-grade leather shoes.
The failure of shock therapy reduced Russia's GDP by almost half, with a total GDP of only 1/10th that of the U.S. The structure of the economy also underwent major changes, with the fuel, power, and metallurgical industries becoming the key sectors of the national economy, with a share of about 15 percent of GDP, 50 percent of the total industrial product mix, and more than 70 percent of exports. Labor productivity in the real sector of the economy is extremely low, if the raw materials and energy sectors are close to the world's average indicators, the other sectors are far below the similar indicators of the U.S. by 20-24%. more than 70% of the production equipment has a service life of more than ten years, which is twice as long as that of the economically developed countries. This situation is a direct consequence of the significant decrease in domestic investment, especially in the real sector of the economy. Foreign investment is reluctant to enter Russia, and the total amount of foreign investment absorbed has accumulated to only $11.5 billion. The overall reduction in Russian spending on scientific and technological development, underinvestment and insufficient attention to innovation have resulted in fewer and fewer competitively priced and quality products on the international market, especially in the market for civilian scientific and technological products, which are crowded out by foreign competitors and where Russian products still account for less than 1% of the share.
The standard of living of the population has fallen even further. By the end of 2000 the total monetary income of Russians was less than 10% of that of Americans, and health conditions and average life expectancy were deteriorating. Some experts estimate that it will take 15 years for Russia's per capita GDP production to reach the level of Portugal or Spain, and for GDP to maintain an annual growth rate of 8 percent.
Russia treats shock therapy as a panacea, and would have liked to create a miracle of institutional turnaround in one step. But the small South American country of Bolivia's treatment program, to the European power Russia, but the medicine is not right. Bolivia was originally engaged in a market economy, few state-owned enterprises, the total economy is not large, coupled with Western powers to help, rely on the market mechanism to iron out inflation, easy to succeed. These conditions, Russia does not account for the same, but prefer to eat a bite of fat, the government to a big spread, engage in spontaneous market regulation, full of thought that the seed is sown by the dragon, but in the end, the harvest is the flea. December 1992, the Gaidar government was dissolved, Russia's shock therapy was also immediately declared a failure.