In which clinical situations is Electroconvulsive Therapy (ECT) typically considered?

• A. Generalized anxiety disorder without depression
• B. Severe major depression with psychotic features or suicidality
• C. Simple insomnia
• D. Panic disorder without depressive features

Answer: (B)

Electroconvulsive therapy is typically considered for severe major depressive episodes, especially when there are psychotic features or suicidality. Its rapid, often dramatic, improvement in depressive symptoms—including mood and psychotic symptoms—makes it a key option when there is urgent risk of self-harm or when a quick stabilization is needed, such as in life-threatening depression or when medications haven’t worked or can’t be used. The other scenarios listed aren’t typical indications because generalized anxiety disorder without depression, simple insomnia, and panic disorder without depressive features are usually treated with psychotherapy, anxiolytics, antidepressants targeting anxiety, or sleep interventions rather than ECT.