O'Dea J F, Mitchell P B, Hickie I B
Division of Psychiatry, Prince Henry Hospital, Little Bay, NSW.
Med J Aust. 1991 Jul 1;155(1):9-11. doi: 10.5694/j.1326-5377.1991.tb116367.x.
We report the findings of the first survey of the practice of electroconvulsive therapy (ECT) for the treatment of depression in Australia and New Zealand. The major aim was to examine the frequency of use of unilateral and bilateral electrode placement, as bilateral ECT has been recently recommended as the treatment of choice by the Royal College of Psychiatrists (UK).
A questionnaire about details of ECT given in the second half of 1989 was forwarded to the medical superintendents of 130 psychiatric hospitals and units in Australia and New Zealand.
Reports were received from 96 psychiatric institutions representing a response rate of 74%. In these units, 915 patients were treated with ECT during the study period. In contrast to depressed patients in the United Kingdom or the United States, a majority of Australian and New Zealand patients given ECT were found to receive unilateral ECT (63%). There were marked regional differences in practice, with patients in New South Wales being more likely to receive unilateral ECT, and those in Queensland and New Zealand bilateral ECT. In the majority of units, bilateral ECT was not considered to be indicated in preference to unilateral ECT for either severe, suicidal or psychotic depression.
The discrepancies between regional practices probably reflect the current uncertainty regarding the balance between the relative efficacy and morbidity of these two forms of treatment. Until these central issues of relative efficacy and morbidity are clarified, it would be inappropriate for local professional bodies to recommend a preferred mode of ECT administration.
我们报告了澳大利亚和新西兰首次关于电休克治疗（ECT）治疗抑郁症实践的调查结果。主要目的是研究单侧和双侧电极放置的使用频率，因为英国皇家精神科医学院最近推荐双侧ECT作为首选治疗方法。
1989年下半年，一份关于ECT详细情况的调查问卷被发送给澳大利亚和新西兰130家精神病医院及科室的医务主任。
收到了96家精神病机构的报告，回复率为74%。在这些单位中，研究期间有915名患者接受了ECT治疗。与英国或美国的抑郁症患者不同，大多数接受ECT治疗的澳大利亚和新西兰患者接受的是单侧ECT（63%）。实践中存在明显的地区差异，新南威尔士州的患者更有可能接受单侧ECT，而昆士兰州和新西兰的患者则接受双侧ECT。在大多数单位中，对于重度、自杀性或精神病性抑郁症，双侧ECT并不被认为比单侧ECT更具优势。
地区实践之间的差异可能反映了目前这两种治疗方式在相对疗效和发病率之间平衡的不确定性。在这些关于相对疗效和发病率的核心问题得到澄清之前，地方专业机构推荐ECT的首选给药方式是不合适的。
