Bowman E S, Coons P M
Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202-5109.
J Nerv Ment Dis. 1992 Aug;180(8):524-8. doi: 10.1097/00005053-199208000-00008.
The psychiatric literature generally discourages the use of electroconvulsive therapy (ECT) to treat depression in dissociative disorder patients, but contains little data on outcome. This prospective study of ECT in three dissociative disorder patients demonstrates that ECT is indicated for severe treatment-resistant depression in such patients. Their Hamilton Depression Scale scores fell by 50%, they were remarkably clinically improved, and they maintained their gains for at least 4 months. The ECT proved helpful when depression was felt by most of the active alters rather than just by one depressed personality. Mini-Mental State Examination scores and clinical observation revealed no unusual confusion or side effects from ECT. These patients' dissociated condition was not altered by ECT, which indicates that ECT neither treats nor impairs treatment of dissociation. Electroconvulsive therapy can be helpful in the overall treatment of dissociative disorders by alleviating severe depressions which block utilization of psychotherapy.
精神病学文献一般不鼓励使用电休克疗法（ECT）治疗分离性障碍患者的抑郁症，但关于治疗结果的数据很少。这项对三名分离性障碍患者进行的ECT前瞻性研究表明，ECT适用于此类患者中严重的难治性抑郁症。他们的汉密尔顿抑郁量表评分下降了50%，临床症状显著改善，且至少4个月保持了改善效果。当大多数活跃的人格状态都感到抑郁而非只有一个抑郁人格时，ECT被证明是有帮助的。简易精神状态检查表评分和临床观察显示，ECT没有引起异常的精神错乱或副作用。ECT并未改变这些患者的分离状态，这表明ECT既不能治疗分离性障碍，也不会损害对分离性障碍的治疗。通过缓解阻碍心理治疗利用的严重抑郁症，电休克疗法有助于分离性障碍的整体治疗。
