Gescher D M, Malevani J
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine Universität, Medizinische Fakultät, LVR-Klinikum Düsseldorf.
Fortschr Neurol Psychiatr. 2012 Mar;80(3):141-8. doi: 10.1055/s-0031-1273298. Epub 2011 Jun 15.
Depressive disorder is a serious and frequent complication in borderline personality disorder (BPD), however, its severity tends to be neglected particularly if symptoms are short-lived or inconsistent as is common in patients with BPD. Yet the high frequency in these patients requires especially rapid and effective therapy to reduce the risks of vital endangerment, chronification and psychosocial impairment. Efficient crisis intervention is essential for continuity of the disease-specific multimodal therapy enabling lasting remission and social and vocational rehabilitation in BPD. In particular with regard to the high incidence of poor or failed pharmacological responses in patients with BPD, electroconvulsive therapy (ECT) is of significant relevance among antidepressant treatment options. Despite the wide consensus on its efficacy, there are only few selected trials on ECT for major depression (MD) in BPD. This review summarises the published original studies on this issue, and critically scrutinises indication, benefits and risks of ECT for MD in BPD. It contributes to a focused, discriminating view on ECT and thus enables an optimised patient-oriented, efficient indication for MD in BPD.
抑郁症是边缘性人格障碍（BPD）中一种严重且常见的并发症，然而，其严重程度往往被忽视，尤其是当症状短暂或不持续时，这在BPD患者中很常见。然而，这些患者中抑郁症的高发病率需要特别快速有效的治疗，以降低危及生命、病情慢性化和社会心理损害的风险。有效的危机干预对于特定疾病的多模式治疗的连续性至关重要，这种治疗能够使BPD患者实现持久缓解以及社会和职业康复。特别是考虑到BPD患者药物反应不佳或无效的高发生率，在抗抑郁治疗选择中，电休克疗法（ECT）具有重要意义。尽管人们对其疗效已达成广泛共识，但针对BPD中重度抑郁症（MD）的ECT研究仅有少数几项。本综述总结了关于这一问题已发表的原始研究，并严格审查了BPD中MD的ECT适应症、益处和风险。它有助于对ECT形成有针对性、有鉴别力的观点，从而能够为BPD中MD制定以患者为导向的优化、有效适应症。
