Methfessel, Isabel

[["dc.bibliographiccitation.firstpage","809"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","European Archives of Psychiatry and Clinical Neuroscience"],["dc.bibliographiccitation.lastpage","817"],["dc.bibliographiccitation.volume","268"],["dc.contributor.author","Krech, Lisa"],["dc.contributor.author","Belz, Michael"],["dc.contributor.author","Besse, Matthias"],["dc.contributor.author","Methfessel, Isabel"],["dc.contributor.author","Wedekind, D."],["dc.contributor.author","Zilles, David"],["dc.date.accessioned","2019-02-26T10:15:46Z"],["dc.date.available","2019-02-26T10:15:46Z"],["dc.date.issued","2018"],["dc.description.abstract","Electroconvulsive therapy (ECT) is the most effective therapy for severe depressive disorders. Though there are known clinical predictors of response (e.g., higher age, presence of psychotic symptoms), there is a lack of knowledge concerning the impact of patients' expectations on treatment outcome and tolerability in terms of possible placebo/nocebo effects. In 31 patients with unipolar or bipolar depressive disorder, we used a questionnaire to investigate the patients' expectations of ECT effectiveness and tolerability prior to and in the course of the treatment. Additionally, the questionnaire was used after the ECT course for a final assessment. Depressive symptoms and putative side-effects were measured at each time point. General linear models were used to analyze the course of depressive symptoms and patients' expectation of ECT effectiveness and tolerability. ECT significantly reduced depressive symptoms with large effect sizes. Patients' rating of ECT effectiveness decreased in parallel: While responders' rating of ECT effectiveness remained stable on a high level, non-responders' rating decreased significantly. Group difference was significant after, but not prior to and during the treatment. Regarding tolerability, there was a (temporary) significant increase in the severity of self-rated symptoms such as headache and memory impairment. In contrast, patients' expectation and assessment of ECT tolerability remained unchanged, and their expectations prior to ECT had no impact on the occurrence of side-effects. These findings contradict the presence of relevant placebo/nocebo effects in the context of ECT when investigating a population of mostly chronic or treatment resistant patients with moderate to severe depressive disorder."],["dc.identifier.doi","10.1007/s00406-017-0840-8"],["dc.identifier.eissn","1433-8491"],["dc.identifier.pmid","28940099"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/57612"],["dc.language.iso","en"],["dc.notes.status","final"],["dc.title","Influence of depressed patients' expectations prior to electroconvulsive therapy on its effectiveness and tolerability (Exp-ECT): a prospective study"],["dc.type","journal_article"],["dc.type.internalPublication","unknown"],["dspace.entity.type","Publication"]]

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[["dc.bibliographiccitation.firstpage","1062"],["dc.bibliographiccitation.issue","9"],["dc.bibliographiccitation.journal","Der Nervenarzt"],["dc.bibliographiccitation.lastpage","1062"],["dc.bibliographiccitation.volume","89"],["dc.contributor.author","Zilles, D."],["dc.contributor.author","Koller, M."],["dc.contributor.author","Methfessel, I."],["dc.contributor.author","Trost, S."],["dc.contributor.author","Simon, A."],["dc.date.accessioned","2020-12-10T14:08:36Z"],["dc.date.available","2020-12-10T14:08:36Z"],["dc.date.issued","2018"],["dc.identifier.doi","10.1007/s00115-018-0595-0"],["dc.identifier.eissn","1433-0407"],["dc.identifier.issn","0028-2804"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/70497"],["dc.language.iso","de"],["dc.notes.intern","DOI Import GROB-354"],["dc.relation.iserratumof","/handle/2/70495"],["dc.title","Erratum zu: Ethik, Evidenz und Elektrokonvulsionstherapie"],["dc.title.alternative","Erratum to: Ethics, evidence and electroconvulsive therapy"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","erratum_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","46"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Der Nervenarzt"],["dc.bibliographiccitation.lastpage","52"],["dc.bibliographiccitation.volume","88"],["dc.contributor.author","Besse, M."],["dc.contributor.author","Methfessel, I."],["dc.contributor.author","Wiltfang, J."],["dc.contributor.author","Zilles, D."],["dc.date.accessioned","2017-09-07T11:45:23Z"],["dc.date.available","2017-09-07T11:45:23Z"],["dc.date.issued","2017"],["dc.description.abstract","Hintergrund Die Elektrokonvulsionstherapie (EKT) ist ein potentes Therapieverfahren, das bei verschiedenen schwerwiegenden psychiatrischen Krankheitsbildern erfolgreich eingesetzt wird. Schwere depressive und psychotische Störungen können mit Einwilligungsunfähigkeit einhergehen. In bestimmten Konstellationen ist daher die Anwendung der EKT auch gegen den natürlichen Patientenwillen möglich. In Deutschland ist dies im Betreuungsrecht geregelt. Ziel der Arbeit Es werden Häufigkeit, Wirksamkeit und Verträglichkeit der EKT dargestellt, wenn sie als ärztliche Maßnahme gegen den natürlichen Willen des Patienten zur Anwendung kommt. Material und Methoden Kasuistik und Literaturübersicht. Ergebnisse Die Literatur zum Thema EKT als ärztliche Maßnahme gegen den natürlichen Willen ist sehr limitiert. Die Häufigkeit für Deutschland wurde 2008 mit weniger als 0,5 % aller mittels EKT behandelten Patienten angegeben. Kasuistiken und Fallserien sprechen für eine gleichermaßen gute Wirksamkeit im Vergleich zur EKT bei vorhandener Einwilligung. Im Behandlungsverlauf stimmte die Mehrzahl der Patienten der Therapie zu und beurteilte diese retrospektiv als hilfreich. Diskussion Die EKT ist bei schwerwiegenden psychiatrischen Störungen auch in ihrer Anwendung gegen den natürlichen Patientenwillen hochgradig wirksam. EKT kann dabei lebensrettend sein und auch aus Patientenperspektive zu einer raschen Besserung der Symptomatik mit Linderung schweren psychischen Leidens führen. Insofern erscheint es unethisch, die EKT in begründeten Einzelfällen nicht als Maßnahme gegen den natürlichen Patientenwillen in Betracht zu ziehen. Ein Konsens mit dem Patienten ist dabei sowohl aus ethischen wie auch aus juristischen Gründen immer zu bevorzugen und sollte im Verlauf schnellstmöglich angestrebt werden."],["dc.identifier.doi","10.1007/s00115-015-0043-3"],["dc.identifier.gro","3151743"],["dc.identifier.pmid","26781243"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/8566"],["dc.language.iso","de"],["dc.notes.status","final"],["dc.notes.submitter","chake"],["dc.relation.issn","0028-2804"],["dc.title","Elektrokonvulsionstherapie gegen den natürlichen Patientenwillen"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","no"],["dspace.entity.type","Publication"]]

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