B. SIVAPRAKASH, MD., Senior Resident, Department of Psychiatry, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Pondicherry - 605006.
Indian J Psychiatry. 2000 Apr;42(2):148-55.
This study analyses the predictors of response to electro-convulsive therapy in major depression The significance of the initial response to ECT as a predictor of outcome was also studied. 30 patients who met the diagnostic catena for major depression, single episode, as defined by DSM-IIIR were treated with 6-10 ECT sessions. Patients who had shown overall improvement by 50% or more on the Hamilton Depression Rating Scale (HDRS) were considered responders. 19 (63.33%) patients were responders while 11 (36.67%) patients were non-responders. These two groups differed significantly with regard to presence/absence of a delusion, diurnal variation of mood, and baseline HDRS score for hypochondriasis. Early improvement in depression was found to have a positive correlation with overall improvement in depression after the full course of ECT. Multiple linear regression analysis showed that approximately 56% of variability m outcome could be explained by the variables hypochondriasis, delusion and diurnal variation of mood taken together. A logistic regression model nosed on these 3 variables classified 83.3% of the patients correctly. The implications of these findings are discussed.
这项研究分析了电抽搐治疗（ECT）对重度抑郁症患者的反应预测因素。还研究了 ECT 初始反应作为预后预测因素的意义。30 名符合 DSM-III-R 定义的单次发作重度抑郁症诊断标准的患者接受了 6-10 次 ECT 治疗。汉密尔顿抑郁评定量表（HDRS）总体改善 50%或更多的患者被认为是有反应者。19 名（63.33%）患者为有反应者，11 名（36.67%）患者为无反应者。这两组在妄想的存在/不存在、心境的昼夜变化和疑病症的基线 HDRS 评分方面存在显著差异。研究发现，抑郁的早期改善与 ECT 全疗程后抑郁的总体改善呈正相关。多元线性回归分析显示，假设将疑病症、妄想和心境昼夜变化这三个变量结合起来，可以解释大约 56%的结局变异性。基于这 3 个变量的逻辑回归模型正确分类了 83.3%的患者。讨论了这些发现的意义。
