Unnati Kumar, MD, Senior Resident, Lady Hardinge Medical College & associated Hospitals, New Delhi 110001, INDIA.
Indian J Psychiatry. 2003 Jan;45(1):26-9.
ECT, though not favoured in the West for treating schizophrenia, is regularly practiced in India for this indication, particularly in poorly responding/treatment resistant cases.Therefore, its role in treatment-resistant schizophrenia is a subject of systematic investigation.
To compare the effectiveness and safety of Electroconvulsive therapy (ECT) in a group of treatment-resistant schizophrenia patients with a control group.
Eligible and consenting patients were randomly allocated to the ECT or Sham ECT groups. Both received antipsychotic drugs.Twenty-five patients completed the study (ECT, n= IS; Sham ECT, n= 10).The study was conducted in a double-blind manner. Clinical change was assessed weekly with BPRS, CGI and adverse event measures.ANOVA for repeated measures and other post-hoc comparisons were used for data analysis.
ECT treated patients improved significantly over successive weeks (p< 0.002) after 6 ECTs, whereas the group receiving sham-ECT did not In both the groups, however, CGI scores did not change significantly, suggesting a dissociated response pattern. ECT was associated with greater relief among carers and lower rehospitalization.
ECT augmentation may well have a significant impact on the clinical course of patients with treatment resistance schizophrenia. It is unclear, but possible, that these changes may be reinforced and maintained by maintenance ECTs. Replication of the present investigation and further studies on maintenance ECT would be rewarding.
尽管电抽搐疗法（ECT）在西方不常用于治疗精神分裂症，但在印度，它经常被用于这种适应症，特别是在反应不佳/治疗抵抗的病例中。因此，ECT 在治疗抵抗性精神分裂症中的作用是系统研究的主题。
比较电抽搐疗法（ECT）在一组治疗抵抗性精神分裂症患者中的疗效和安全性与对照组。
符合条件并同意的患者被随机分配到 ECT 或假 ECT 组。两组均接受抗精神病药物治疗。25 名患者完成了研究（ECT 组，n=13；假 ECT 组，n=10）。该研究采用双盲法进行。使用 BPRS、CGI 和不良反应措施每周评估临床变化。采用重复测量方差分析和其他事后比较进行数据分析。
ECT 治疗组在接受 6 次 ECT 后，每周的临床改善明显（p<0.002），而接受假 ECT 组则没有。然而，在两组中，CGI 评分均无显著变化，提示存在分离反应模式。ECT 与照料者的更大缓解和较低的再住院率相关。
ECT 增强可能对治疗抵抗性精神分裂症患者的临床病程产生重大影响。目前尚不清楚，但有可能，这些变化可能通过维持性 ECT 得到加强和维持。复制本研究和进一步的维持性 ECT 研究将是有益的。
