Moksnes Kjell Martin
Department of Geriatric Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Tidsskr Nor Laegeforen. 2011 Oct 18;131(20):1991-3. doi: 10.4045/tidsskr.10.1349.
Irrespective of the treatment method used, there is a strong tendency to relapse into depression if treatment terminates. The purpose of this retrospective study is to investigate the relapse rate and the time elapsing before relapse after electroconvulsive treatment (ECT) and what was done to prevent this.
The ECT records and case notes of patients who received electroconvulsive therapy in the period 1960 - 1995 at three psychiatric departments at Dikemark Hospital were systematically reviewed. Relapse was defined as recorded, definite recurrence of depressive symptoms in patients who had achieved an improvement following a series of ECT treatments. The observation period is defined as the time since completing the first ECT series at Dikemark, up to and including 31 December 1995.
The median observation period following the patient's first ECT series at Dikemark was nine years (spread: 3 months - 44 years). Of 120 patients, 56 (47 %) who were described as show-ing an improvement after the first ECT series suffered a relapse in the course of the first six months. A total of 86 (72 %) suffered a relapse after an average of 13 months (median three months), but none of the seven who improved following their first-time depression suffered a relapse. After the first ECT series, 84 patients (70 %) received antidepressants and/or lithium to prevent relapse. An improvement was described after 87 of 100 repeated ECT series that were administered to 46 patients. In 58 (67 %) of these cases, relapse occurred within six months.
The relapse rate was high. The results indicate that follow-up treatment with antidepressants after electroconvulsive therapy should be supplemented with other measures to reduce the rate of relapse in cases of depression.
无论采用何种治疗方法，治疗结束后都有很强的抑郁症复发倾向。这项回顾性研究的目的是调查电休克治疗（ECT）后的复发率以及复发前经过的时间，以及为预防复发所采取的措施。
系统回顾了1960年至1995年期间在迪克马克医院三个精神科接受电休克治疗的患者的ECT记录和病历。复发定义为在接受一系列ECT治疗后病情有所改善的患者出现记录在案的、明确的抑郁症状复发。观察期定义为自迪克马克首次完成ECT系列治疗起至1995年12月31日（含该日）的时间。
患者在迪克马克首次接受ECT系列治疗后的中位观察期为9年（范围：3个月至44年）。120名患者中，56名（47%）在首次ECT系列治疗后病情有所改善，但在头六个月内复发。共有86名（72%）患者在平均13个月（中位数为3个月）后复发，但首次抑郁症发作后病情改善的7名患者均未复发。首次ECT系列治疗后，84名患者（70%）接受了抗抑郁药和/或锂盐以预防复发。对46名患者进行的100次重复ECT系列治疗中，有87次治疗后病情有所改善。其中58例（67%）在六个月内复发。
复发率很高。结果表明，电休克治疗后用抗抑郁药进行后续治疗应辅以其他措施，以降低抑郁症患者的复发率。
