Psy-World

Newcastle Diagnostic and ECT prognosis Scales

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Original reference Carney MWP, Roth M, Garside RF. The diagnosis of depressive syndromes and the prediction of ECT response. Brit J Psychiatr. 1965; 111: 659-674.   These scales were developed for the diagnosis of endogenous depression and the likely response to electroconvulsive therapy (ECT). Note: These scales are not applicable to depression secondary to psychosis, organic cerebral disease, epilepsy, drug addiction, or subnormality   Explanation of items for depression scale: (1) adequate personality (no personality deviation): free from a history of neurotic breakdown and without disabling neurotic symptoms or serious social maladjustments (2) no adequate psychogenesis: no psychological stress or difficulty continuing to operate after the onset of symptoms and adequate to explain perpetuation of the illness (3) distinct quality: a quality distinct from the depression/gloom/sadness with which they usually react to adversity (4) weight loss (5) previous episode of depression (6) depressive psychomotor activity: agitation, slowing or retardation (7) anxiety (8) nihilistic delusions: delusions of doom, imminent destruction, somatic dissolution or poverty of the patient and/or his family (9) blame others for illness (accusations of others) (10) feelings guilt, delusions of guilt

Depression Parameters	Finding	Points
adequate personality	present	1
	absent	0
no adequate psychogenesis	present	2
	absent	0
distinct quality	present	1
	absent	0
weight loss	present	2
	absent	0
previous episode	present	1
	absent	0
depressive psychomotor activity	present	2
	absent	0
anxiety	present	-1
	absent	0
nihilistic delusions	present	2
	absent	0
blaming others	yes	-1
	no	0
guilt	present	1
	absent	0
ECT Parameters	Finding	Points
weight loss	present	3
	absent	0
pyknic (short, thick and stocky)	present	3
	absent	0
early wakening	present	2
	absent	0
anxiety	present	-2
	absent	0
somatic delusions	present	2
	absent	0
paranoid delusions	present	1
	absent	0
worse in the afternoon and evening	present	-3
	absent	0
self pity	present	-1
	absent	0
hypochondriacal	present	-3
	absent	0
hysterical	present	-3
	absent	0
ECT score = total score for all 10 parameters (possible score -12 to 11) Interpretation: An ECT score >1 indicates a probable good result from ECT, while < 1 indicates a probable poor outcome.