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Electroconvulsive therapy (ECT) is a controversial psychiatric treatment involving the induction of a seizure in a patient by passing electricity through the brain. While beneficial effects of electrically Induced seizures are evident and predictable in most patients, a unified mechanism of action has not yet been established and remains the subject of numerous investigations. ECT is extremely effective against severe depression, some acute psychotic states, and mania, though, like many medical procedures, It has its risks.
Since the inception of ECT in 1938, the public has held a strongly negative conception of the procedure. Initially, doctors employed unmodified ECT. Patients were rendered Instantly unconscious by the electrical current, but the strength of the muscle contractions from uncontrolled motor seizures often led to compression fractures of the spine or damage to the teeth. In addition to the effect this physical trauma had on public sentiment graphic examples of abuse documented In books and movies, such as Ken Kesey's One Flew Over the Cuckoo's Nest, portrayed ECT as punitive, cruel, overused, and violative of patients' legal rights.
Modem ECT is virtually unrecognizable from Its earlier days. The treatment Is modified by the muscle relaxant succinylcholine, which renders muscle contractions practically nonexistent. Additionally, patients are given a general anesthetic. Thus, the patient is asleep and fully unaware during the procedure, and the only outward sign of a seizure may be the rhythmic movement of the patient's hand or foot. ECT is generally used In severely depressed patients for whom psychotherapy and medication prove ineffective. It may also be considered when there Is an imminent risk of suicide, since antidepressants often take several weeks to work effectively. Exactly how ECT exerts its effects is not known, but repeated applications affect several neurotransmitters In the brain, Including serotonin, norepinephrine, and dopamine.
ECT has proven effective, but it Is not without controversy. Though decades old studies showing brain cell death have been refuted in recent research, many patients do report loss of memory for events that occurred in the days, weeks, or months surrounding the ECT. Some patients have also reported that their short-term memories continue to be affected for months after ECT, though some doctors argue that this memory malfunction may reflect the type of amnesia that sometimes results from severe depression.
1. According to the passage, why has ECT been viewed negatively by the public?
(A) Though ECT is effective in many cases, the medical community is not certain exactly how it works.
(B) Cultural depictions of ECT implied that the therapy infringed upon the lawful rights of those receiving the treatment.
(C) Effective use of ECT requires exposure to concerning medications, such as muscle relaxants and anesthesia.
(D) ECT does not benefit individuals with anxiety disorders.
(E) ECT cannot be performed without subsequent loss of memory in the patient.
2. Which of the following can be inferred about the way in which the modern form of ECT works?
(A) Greater amounts of the neurotransmitters serotonin, norepinephrine, and dopamine seem to reduce symptoms of depression.
(B) ECT cannot be used prior to attempting psychotherapy or medication.
(C) Succinylcholine completely immobilizes the patient's body.
(D) ECT generally works faster than antidepressants.
(E) One ECT treatment is often sufficient to reduce symptoms of depression significantly.
3. The author mentions amnesia as a possible side effect of severe depression in order to
(A) acknowledge one of the possible negative side effects associated with ECT
(B) emphasize the seriousness of severe depression as a debilitating disease
(C) introduce a possible alternative cause for short-term memory loss reported by some patients
(D) draw a connection between brain cell death and short-term memory loss
(E) refute claims that ECT is responsible for any form of amnesia in patients
4. Each of the following is cited in the passage as a current or historical criticism of electroconvulsive therapy EXCEPT
(A) ECT may cause the death of brain cells and memory loss
(B) in certain cases, ECT was portrayed as a means to punish individuals
(C) ECT had the potential to be used in inappropriate situations
(D) early forms of ECT did not adequately protect patients from secondary harm brought on by the treatment
(E) repeated applications of ECT affect several neurotransmitters in the brain
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发表于 2021-4-9 16:22:39
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