In 1935, the Hungarian neuropsychiatrist Von Meduna thought that schizophrenia and epilepsy were two mutually antagonistic disorders (which later proved to be incorrect), and thus created spasmotherapy with the drug cardiazole (Fink 1984). In 1938, Creletti and Bini invented electroconvulsive therapy, which is easy to operate, easy to grasp and has fewer side effects, so it quickly replaced drug spasm therapy and was widely used. China is also the first to use drug spasm therapy, and then the application of electroconvulsive therapy. Electric convulsive therapy (ECT) is also known as electric shock therapy (EST). It is a treatment method to control psychiatric symptoms by passing a certain amount of electric current through the brain within a safe range, causing loss of consciousness, widespread cortical EEG and generalized spasticity. I. Indications 1. Severe depression, strong self-injury, suicide attempts and behavior, as well as obvious self-blame and self-criminalization; 2. Severe excitement, extreme excitement, agitation, impulsiveness, injury; 3. Refusal to eat, disobedience and nervousness of wood stiffness; 4. Psychotropic drug treatment is ineffective or intolerant to drug treatment. Contraindications 1. Organic brain diseases: intracranial occupying lesions, cerebrovascular diseases, inflammation of the central nervous system, epileptic seizures and trauma. Brain tumors or cerebral aneurysms should be especially noted, because when convulsions occur, the intracranial pressure will suddenly increase, easily causing cerebral hemorrhage, brain tissue damage or brain herniation;. 2, cardiovascular diseases: coronary heart disease, myocardial infarction, hypertension, arrhythmia, aortic aneurysm and cardiac insufficiency; 3, diseases with potential risk of glaucoma or retinal detachment. 4.Severe respiratory diseases, severe liver and kidney diseases. 5.Severe endocrine disease, combined with significant malnutrition, or combined with water and electrolyte disorders. 6, bleeding or unstable aneurysmal deformity; 7, bone and joint diseases, especially the recent occurrence, significant scoliosis or a history of compression fracture, various arthritis and joint movement disorders. 8, acute systemic infection, fever. 9.The elderly, children and pregnant women. 10.Muscularly developed and strong people. III. Pre-treatment preparation 1. Obtain informed consent. In order to fully express the risks and benefits, the consent form should include the following information: (1) Who recommended the use of ECT treatment and for what reasons. (2) A description of other alternative treatments for available patients. (3) A description of the treatment procedure for ECT, including the number of treatments and when they will be given and the place where they will be given. (4) Discuss with the patient the advantages and disadvantages of different types of methods of placing stimulating electrodes and explain the rationale for giving the patient a particular type of treatment. (5) After the maximum number of treatments that can be performed in a session has been fully completed, if continued treatment is still required, indicate to the patient that informed consent for that treatment needs to be renewed. (6) To indicate that treatment with ECT is not guaranteed to be definitely effective. (7) To indicate that the patient is at risk of recurrence after ECT treatment, and to indicate some other treatment that the patient should undergo after ECT treatment. (8) Indicate the likelihood of the risk occurring (very rare, rare, uncommon, or common) and the severity of the major risks, including fatalities, cardiovascular adverse effects, central nervous system adverse effects (including transient and long-term perceptual aspects), and some other common minor negative effects. (9) Informed consent for ECT should also include informed consent that the hospital has the right to take appropriate emergency measures if the patient presents with an indication that requires clinical emergency care. (10) A description of what behavioral limitations the patient has during the pre-ECT evaluation, during ECT treatment, and during the recovery period of the disease. (11) If the patient has questions about the recommended treatment plan, provide a person who is available at any time to answer such questions, specifying the name of this person and how to contact them. (12) Indicate that informed consent for ECT is entirely voluntary and can be opted out at any time. 2. A detailed physical examination, including a neurological examination. If necessary, laboratory tests and ancillary examinations such as routine blood work, blood biochemistry, electrocardiogram, electroencephalogram, chest and spine radiographs. 3. No anti-epileptic and anti-anxiety drugs are used for 8 hours before treatment to avoid undesirable seizures; lower doses of antipsychotics or antidepressants or lithium salts applied during treatment should be used. 4, the preparation of the treatment room: quiet, avoid noise, spacious and bright (light should not be too strong), room temperature to maintain 18-26 ℃; prepare emergency drugs and resuscitation appliances; electroconvulsive therapy appliances: power supply, electrotherapy machine, conductive gel, small sand pillow, dry towel, treatment table, dental pads, hard board bed, wrapped in gauze tongue depressor. 5.Fast 8 hours before treatment, 4 hours of water fasting, evacuation of urine and feces. 6.Temperature, pulse, respiration and blood pressure before treatment and recorded in the treatment sheet; temperature, pulse and blood pressure were measured before treatment. If the body temperature is above 37.5℃, pulse rate is above 120 beats/min or below 50 beats/min, blood pressure is above 150/100mmHg or below 90/50mmHg, it should be disabled. 7.Empty the bowels and urine, remove the movable denture, hairpin, untie the collar buckle and belt before doing the treatment. 8.Pre-treatment medication: usually subcutaneous injection of atropine 0.5~1.0mg 15~30 minutes before treatment to prevent vagus nerve overexcitation and reduce secretion. If the respiratory recovery is not good in the first treatment, subcutaneous injection of Lopressor 3.0~6.0mg can be given 15~30 minutes before each subsequent treatment; IV. Treatment course Generally set at 6~12 times. In the first week and the second week, once every other day, i.e. 3 times a week; in the third week and the fourth week, once every 3 days, i.e. 2 times a week; in the fifth and sixth week, once. It can be increased or decreased according to the condition. Generally, about 6 times for manic state is sufficient; 8-12 times for hallucinatory delusional state; between the two for depressive state. V. ECT complications and treatment 1. Common symptoms Headache, nausea, vomiting, anxiety, reversible memory loss, generalized muscle aches and pains, etc., do not require special treatment, and heavy symptomatic treatment. Memory loss mostly recovers within a few weeks after stopping treatment. 2, prolonged apnea Generally with convulsive electroconvulsive treatment within 10-30 seconds after the cessation of convulsions breathing resumes on its own, without convulsive electroconvulsive treatment within 5 minutes breathing resumes on its own. If it is not recovered in time, artificial respiration and oxygen should be administered immediately. Causes of prolongation may be central depression, airway blockage, posterior tongue collapse or excessive use of sedatives. 3, fracture and dislocation There is convulsive electroconvulsive treatment due to sudden and violent muscle contraction can cause fracture and dislocation. Dislocation is more frequent in the lower jaw, and fractures are most common in compression fractures of the 4th-8th thoracic vertebrae. 4. Patients who are older and apply drugs with anticholinergic effect during treatment are more likely to have impaired consciousness (mild degree, light day and night, persistent disorientation, may have visual hallucinations) and impaired cognitive function (slow thinking and reaction, memory and comprehension). At this time, electroconvulsive therapy should be discontinued. 5. Asphyxia is one of the serious complications of ECT, and cardiac complications are rare. Death is extremely rare and is mostly associated with underlying somatic diseases.