van Beusekom Babette S, van den Broek Walter W, Birkenhäger Tom K
Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands.
J ECT. 2007 Mar;23(1):17-20. doi: 10.1097/01.yct.0000263255.98796.30.
A long-term follow-up of depressed patients responsive to electroconvulsive therapy (ECT) with intensive pre-ECT pharmacotherapy treatment failure who also participated in a 6-month trial directly post-ECT in which imipramine was compared with placebo for relapse prevention.
A total of 26 patients responsive to ECT who participated in the 6-month continuation trial were invited 4 to 8 years later to assess their follow-up status. The groups with and without relapse within 6 months were compared with regard to recurrence of depression up to 8 years later. Recurrence was defined as a new episode of depression that needed antidepressant medication and/or readmission in hospital and/or a new ECT course.
At the time of follow-up (mean duration, 6.8 years), the recurrence rate of depression for the total sample was 42.3%. There was no significant difference in the recurrence rates and number of recurrences between the nonrelapse and relapse groups. The small study population limits generalization of the results; the design of the study is naturalistic and retrospective.
In our small sample of depressed patients with pharmacotherapy treatment failure, recurrence is not influenced by relapse after terminating ECT. Continuation of medication started immediately after ECT seems to be an important factor in preventing recurrence.
对电休克治疗（ECT）有反应的抑郁症患者进行长期随访，这些患者在ECT前强化药物治疗失败，且在ECT后直接参加了一项为期6个月的试验，该试验将丙咪嗪与安慰剂用于预防复发进行比较。
4至8年后，邀请了总共26名对ECT有反应且参加了6个月延续试验的患者，以评估他们的随访状况。比较了6个月内有无复发的两组患者在8年后抑郁症复发的情况。复发定义为需要抗抑郁药物治疗和/或再次住院和/或接受新的ECT疗程的新的抑郁发作。
在随访时（平均时长6.8年），总样本的抑郁症复发率为42.3%。未复发组和复发组之间的复发率和复发次数没有显著差异。研究样本量小限制了结果的推广；该研究设计是自然主义的且为回顾性的。
在我们这个药物治疗失败的抑郁症患者小样本中，ECT结束后的复发情况不会影响复发率。ECT后立即开始持续用药似乎是预防复发的一个重要因素。
