Scarano V R, Felthous A R, Early T S
Forensic Psychiatry Services, Baylor College of Medicine, Houston, TX 77030, USA.
J Forensic Sci. 2000 Nov;45(6):1197-202.
The Texas Legislature in 1993 mandated a quarterly reporting requirement for hospitals and physicians performing electroconvulsive therapy (ECT) in the state (United States Government hospitals were excluded). The Texas Department of Mental Health and Mental Retardation (TDMHMR) was designated as the agency responsible for collecting and maintaining the data. This paper reviews the ECT data from 16 quarterly reports (09/01/93 through 08/31/97). The reports contained data on 41,660 ECT treatments in approximately 5971 patients. The results of this study support the proposition that ECT is an extremely safe and effective treatment for those individuals suffering from a serious mental illness. In Texas, ethnic groups other than non-Hispanic Anglo-Americans appear to be underserved in regards to ECT. Those patients without appropriate insurance or adequate personal finds are also underserved as a result of the few county and state hospitals performing ECT and the relatively small number of patients treated with ECT at those hospitals. Recommendations are suggested to improve the quality of the database and in informing the public as to the safety and efficacy of this valuable treatment modality. What, at first, was seen as an unwarranted legislative foray into the practice of medicine, has, in the end, become a source of valuable data supporting the use of ECT as an important treatment modality.
1993年，得克萨斯州立法机构规定该州（不包括美国政府医院）实施电休克疗法（ECT）的医院和医生需每季度提交报告。得克萨斯州精神健康与智力障碍部（TDMHMR）被指定为负责收集和保存这些数据的机构。本文回顾了16份季度报告（从1993年9月1日至1997年8月31日）中的ECT数据。这些报告包含了约5971名患者的41660次ECT治疗的数据。本研究结果支持以下观点：ECT对于患有严重精神疾病的个体而言是一种极其安全有效的治疗方法。在得克萨斯州，除非西班牙裔盎格鲁美国人之外的其他种族群体在ECT治疗方面似乎未得到充分服务。由于进行ECT治疗的县级和州级医院数量较少，且这些医院接受ECT治疗的患者数量相对较少，那些没有适当保险或足够个人资金的患者也未得到充分服务。文中提出了一些建议，以提高数据库质量，并让公众了解这种有价值的治疗方式的安全性和有效性。最初被视为对医疗实践无端干涉的立法行为，最终却成为了支持将ECT作为一种重要治疗方式使用的宝贵数据来源。
