The suffering of depressed patients is enormous. It also poses an important burden on their significant others and on society as a whole. Clinicians are therefore being urged to relieve these... Show moreThe suffering of depressed patients is enormous. It also poses an important burden on their significant others and on society as a whole. Clinicians are therefore being urged to relieve these conditions as soon as possible. To that purpose, effective psychotherapeutic, psychopharmacologic and other biological interventions, such as electroconvulsive therapy (ECT), are available. Observing a quick response to a course of ECT in a psychotic depressed patient is astonishing. ECT may restore the patient__s normal mood, but at the same time may provoke anxiety and a sense of shame or stigmatization. Frequently, ECT is accompanied by more or less impairing cognitive side effects. For clinicians and scientists, ECT is fascinating and raises many research questions concerning the effects of this treatment on the functioning of the brain. This thesis reports on our daily practice in which we treat severely ill depressed patients, while simultaneously doing clinical research. To further improve the understanding and the effectiveness of ECT, the electrical dose, which elicits the seizure activity (defined as seizure threshold [ST]), is the subject of this thesis Show less
