Sareen J, Enns M W, Guertin J E
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
J ECT. 2000 Mar;16(1):43-51. doi: 10.1097/00124509-200003000-00006.
Clinical experience suggests that patients with depression and a comorbid personality disorder (PD) may have a poorer response to electroconvulsive therapy (ECT). Only a few published studies have examined the relationship between comorbid personality disorders and response of major depression to ECT. These studies have used relatively small numbers of patients. The present study is a retrospective review of 107 inpatients with a major depressive episode referred for ECT. Patients with a clinically diagnosed PD, especially a cluster B PD, had a significantly poorer acute response to ECT than those without a PD. During the first year after treatment, ECT responders with a comorbid PD had a higher rate of relapse of depression. The retrospective study design limits the strength of conclusions that can be drawn. Nevertheless, it appears that clinically diagnosed PDs may be predictive of poor outcome in patients receiving ECT for depression. Further prospective study of the relationship between both clinically diagnosed PDs and structured interview based PD diagnoses and ECT treatment response is warranted.
临床经验表明，患有抑郁症且合并人格障碍（PD）的患者对电休克疗法（ECT）的反应可能较差。仅有少数已发表的研究探讨了合并人格障碍与重度抑郁症对ECT反应之间的关系。这些研究纳入的患者数量相对较少。本研究对107例因ECT转诊的重度抑郁发作住院患者进行了回顾性分析。临床诊断为PD的患者，尤其是B类人格障碍患者，对ECT的急性反应明显比无PD的患者差。在治疗后的第一年，合并PD的ECT应答者抑郁症复发率更高。回顾性研究设计限制了所得结论的力度。尽管如此，临床诊断的PD似乎可能预示着接受ECT治疗抑郁症的患者预后不良。有必要对临床诊断的PD以及基于结构化访谈的PD诊断与ECT治疗反应之间的关系进行进一步的前瞻性研究。
