Editorial board editor-in-chief

DIFFICulTIES IN DEVElOPING AlGORITHmS FOR APPlICATION 
OF PHYSICAl mETHODS OF TREATmENT OF DEPRESSIONS: 
ElECTROCONVulSIVE THERAPY AS wEll AS OTHER mETHODS
OF ElECTRIC AND mAGNETIC STImulATION
t
oMAsz
z
yss
Department of Adult Psychiatry, University Hospital, Medical College of Jagiellonian University,
Kraków, Poland; e-mail: 
[e-mail]
Abstract:
 
Therapeutic algorithms constitute a kind of aid for selection of an appropriate method of treatment and its subsequent 
stages, with regard to different diseases in order to achieve the highest effectiveness of the therapy. The work describes prem
-
ises and dificulties in development of therapeutic algorithms, with regard to a number of physical methods which are applied 
in psychiatry in treatment of depressive disorders, and which make use of the phenomena of magnetic or electric stimulation.
Keywords:
ECT, physical treatments, therapy algorithms
its disposal. The latter ones include various psychotherapeutic 
schools while among the biological ones we can distinguish 
pharmacotherapy, phototherapy and methods of magnetic as 
well as electric stimulation. The present work discusses the 
latest two of the methods listed above. 
Historical trait
Methods of treatment relect the present state of medical 
knowledge – mostly in the area of etiology. This is why for centu
-
ries the methods of treatment in psychiatry have been related with 
beliefs and knowledge (or, rather, ignorance) about the nature and 
origins of mental disorders, which, in fact, have been identiied 
quite recently. In the 18
th
century, Giovanni Fantoni, a professor 
of the University in Turin, claimed that the structure of the brain 
is unknown, the disorders connected with it are inconceivable 
and its functions - impossible to comprehend (Obscura textura, 
obscuriore smorbi, functiones obscurissime) [3]. It was as late 
as the 19
th
century that the modern systems of classiication 
of mental disorders taking into account nosological elements 
came into being. The beginning of the 20
th
century brought about 
new methods of therapy including shock therapies (including 
cardiazol and indoklon shocks as well as electroconvulsions), 
sleep therapy (prolonged sleep therapy, insulin coma therapy) 
Introduction
Clinical studies performed on large groups of patients as well 
as clinical observations allow for determination of the optimum 
methods of therapy. A therapeutic stepladder can be described, 
informing what forms of therapy should start the treatment in 
a given disease unit and how the treatment should progress at 
the subsequent stages if the irst selected therapy proves inef
-
fective or too little effective. At the second and further stages, 
the therapeutic stepladder may consist of several steps. This 
is the way to create algorithms of treatment, i.e., schemes of 
conduct allowing the physician to operationalize the therapeutic 
process [1].
Although their simple forms have been is use for several 
centuries, therapeutic algorithms are an achievement of modern 
medicine, which offers several different forms of therapy or medi-
cation, either in a non-invasive form (usually as pharmacotherapy) 
or as invasive methods (various kinds of surgical operations), ect., 
for any given disease unit. Thanks to experiments on animals and 
clinical studies it is now possible to assess both the effectiveness 
of a given method and its safety. Sometimes strengthening of 
the former feature (effectiveness) requires joint administration 
of several methods of therapy [2].
Unlike many other medical specializations, psychiatry of-
fers a wide range of various methods of treatment of different 
mental disorders, which issues partly from their poly-etiological 
character. It has both biological and non-biological techniques at 

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