ECT is one of the most effective treatments in psychiatry, and it’s important to keep it in mind for a variety of inpatients—especially those with treatment resistant depression and psychotic depression. In this fact sheet, we are assuming that you are not the one actually doing the ECT treatment, but rather that you will be referring your patient to an ECT program either in your hospital or for transport elsewhere. Thus, our focus will be on how you will discuss ECT with your patient, how you will coordinate with the ECT consultant, and how you will manage your inpatient in between ECT treatments.

: Health Care Proxy (HCP) and Power of Attorney (POA) are types of advance directives, which are legal documents allowing individuals to designate someone else to make decisions on their behalf, particularly when they are incapacitated. Unlike conservatorships or guardianships, which are court-assigned, advance directives like HCP and POA allow the individual to proactively choose a representative. This delegate is tasked with making decisions that align with the person’s wishes and values, encompassing medical, legal, and occasionally financial matters. This fact sheet delves into these important legal tools.

● Major depression

         Depressed mood + SIGECAPS (4 of 8) o SIGECAPS: sleep, interest, guilt,             energy, concentration, appetite, psychomotor, suicide

When a patient threatens to kill someone, immediate action is necessary: 1. Evaluate the patient's intent, capability, and history of violence or aggression. Consider the specificity of the threat, including details about the potential victim and the plan. 2. Ensure the safety of the patient, staff, and others by implementing appropriate security measures within the unit.

: A rare but potentially life-threatening drug reaction presenting with muscle rigidity (“lead pipe”), hyperthermia, and altered mental status. May present similarly to serotonin syndrome although may be less acute in onset (within days vs hours).

: Excessive sweating, which tends to be more prominent in the face, neck, and chest, and less prominent in the armpits and palms.

Typically, patients will report food craving and binging. Weight gain is rapid in the first three months, more gradual over the following year, then often plateaus. Rapid initial weight gain is correlated with greater eventual cumulative weight gain. FDA definition of weight gain is ≥7% increase in weight from baseline.

 involuntary movements, usually occurring after months or years of antipsychotic treatment. The most common symptoms are oro-buccal-lingual, such as chewing, lip smacking, and tongue protrusion. Occasionally causes movements of fingers or toes and rarely, in severe cases, may affect torso and gait.

Patients with intellectual disabilities (ID) may be admitted to adult inpatient units for a range of issues, often related to self-harm or impulsive violence toward caregivers. This fact sheet offers a concise review of intellectual disabilities and provides guidelines for their management in an adult inpatient unit.

Rapid regular movements of body parts, especially hands. Classified as fine vs coarse, and as resting vs postural vs intention.