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[电休克治疗对55例56岁及以上患有情绪障碍和躯体合并症的患者有效且安全]

[Electroconvulsive therapy effective and safe in 55 patients aged 56 years and older with mood disorders and physical comorbidity].

作者信息

van Waarde J A, Stek M L

机构信息

Geestelijke Gezondheidszorg (GGZ) Buitenamstel, locatie Valeriuskliniek, Valeriusplein 9, 1075 BG Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 2001 Sep 1;145(35):1693-7.

Abstract

OBJECTIVE

To determine the efficacy and safety of electroconvulsive therapy (ECT) in patients aged 56 years and older with mood disorders who had failed to respond to pharmacotherapy.

DESIGN

Retrospective, descriptive.

METHOD

Demographic data, illness and treatment characteristics were registered for all patients (age > or = 56 years) treated with ECT in the period 1 January 1998 to 31 December 2000. The efficacy of ECT was evaluated with the 'Montgomery-Asberg depression rating scale' (MADRS) and cognitive side effects were evaluated with the 'Mini-mental state examination' (MMSE). Descriptive statistical methods were used for the analysis.

RESULTS

A total of 58 treatments were evaluated in 55 patients with a mean age of 73 years. Most patients had a recurrent depressive disorder with physical comorbidity that did not respond to pharmacotherapy. An average of 12 ECT sessions were given per treatment. In patients where a MADRS score was known before and after ECT, 74% exhibited a significant improvement and 48% reached a complete remission of the depression. Cognitive side effects occurred in 28% of the patients. No serious physical complications were reported.

CONCLUSION

ECT is an essential means of intervention in treating mood disorders of the elderly and should be considered in an earlier phase, especially in patients with physical comorbidity.

摘要

目的

确定电休克疗法(ECT)对56岁及以上药物治疗无效的情绪障碍患者的疗效和安全性。

设计

回顾性、描述性研究。

方法

记录1998年1月1日至2000年12月31日期间接受ECT治疗的所有患者(年龄≥56岁)的人口统计学数据、疾病和治疗特征。用“蒙哥马利-阿斯伯格抑郁评定量表”(MADRS)评估ECT的疗效,用“简易精神状态检查表”(MMSE)评估认知副作用。采用描述性统计方法进行分析。

结果

共评估了55例平均年龄为73岁患者的58次治疗。大多数患者患有复发性抑郁症且伴有躯体合并症,药物治疗无效。每次治疗平均进行12次ECT疗程。在ECT前后已知MADRS评分的患者中,74%表现出显著改善,48%达到抑郁症完全缓解。28%的患者出现认知副作用。未报告严重的躯体并发症。

结论

ECT是治疗老年情绪障碍的重要干预手段,应在更早阶段考虑使用,尤其是伴有躯体合并症的患者。

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