Ikeji O C, Ohaeri J U, Osahon R O, Agidee R O
Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
East Afr Med J. 1999 Nov;76(11):644-50.
Although unmodified electro-convulsive therapy (ECT) is widely used in Nigeria for schizophrenia, mania and severe depression failing to respond to adequate pharmacotherapy in the short-term, there are no prospective studies on its efficacy and side effects.
To compare the efficacy of electro-convulsive therapy and standard pharmacotherapy in the treatment of schizophrenia, mania and severe depression.
A prospective open label study.
Seventy subjects (mean age, 29.4) with mean duration of illness, 50.6 months, and diagnosis of schizophrenia (37.1%), mania (28.6%), severe depression (30%) and schizo-affective disorder (4.3%), were assessed pre-ECT and at seven other intervals in six months, using the Brief Psychiatric Rating Scale (BPRS), the Mini-Mental State Examination (MMSE) and other cognitive test batteries. They were compared with a matched group of patients who received only pharmacotherapy.
Although the ECT group had suffered more treatment resistant disorders, there was full clinical recovery in two months, when all were discharged. The group had significantly shortened duration of hospitalisation, after commencement of ECT. Hence ECT facilitated recovery in this potentially drug treatment resistant psychotic subjects. Although frequency of complaints of subjective memory difficulty increased during ECT and normalised at follow up, objective tests showed steady cognitive improvement with clinical recovery. Complaints of muscle pain (31.4%), post-ECT confusion (15.7%) and post-ECT headache (20%) in the first week of treatment, were not evident at follow up.
Unmodified ECT combined with pharmacotherapy was safe and effective with non-enduring subjective memory difficulty for this potentially drug treatment resistant group of psychotic patients.
尽管在尼日利亚，未改良的电休克治疗（ECT）被广泛用于治疗精神分裂症、躁狂症以及短期足量药物治疗无效的重度抑郁症，但尚无关于其疗效和副作用的前瞻性研究。
比较电休克治疗与标准药物治疗在精神分裂症、躁狂症和重度抑郁症治疗中的疗效。
一项前瞻性开放标签研究。
选取70名受试者（平均年龄29.4岁），平均病程50.6个月，诊断为精神分裂症（37.1%）、躁狂症（28.6%）、重度抑郁症（30%）和分裂情感性障碍（4.3%），在ECT治疗前及治疗后六个月内的其他七个时间点，使用简明精神病评定量表（BPRS）、简易精神状态检查表（MMSE）及其他认知测试组合进行评估。将他们与一组仅接受药物治疗的匹配患者进行比较。
尽管ECT组中难治性疾病患者更多，但两个月时所有患者均临床痊愈出院。ECT组在开始ECT治疗后住院时间显著缩短。因此，ECT促进了这些潜在药物治疗难治性精神病受试者的康复。尽管ECT治疗期间主观记忆困难的主诉频率增加，但随访时恢复正常，客观测试显示随着临床康复认知功能稳步改善。治疗第一周出现的肌肉疼痛主诉（31.4%）、ECT后意识模糊（15.7%）和ECT后头痛（20%）在随访时均未出现。
对于这组潜在药物治疗难治性精神病患者，未改良的ECT联合药物治疗安全有效，且主观记忆困难不持久。
