de la Serna Elena, Flamarique Itziar, Castro-Fornieles Josefina, Pons Alexandre, Puig Olga, Andrés-Perpiña Susana, Lázaro Luisa, Garrido Juan Miguel, Bernardo Miguel, Baeza Inmaculada
Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.
J Child Adolesc Psychopharmacol. 2011 Dec;21(6):611-9. doi: 10.1089/cap.2011.0012. Epub 2011 Dec 2.
The aim of the current study was to investigate the long-term cognitive effects of electroconvulsive therapy (ECT) in a sample of adolescent patients in whom schizophrenia spectrum disorders were diagnosed.
The sample was composed of nine adolescent subjects in whom schizophrenia or schizoaffective disorder was diagnosed according to DSM-IV-TR criteria on whom ECT was conducted (ECT group) and nine adolescent subjects matched by age, socioeconomic status, and diagnostic and Positive and Negative Syndrome Scale (PANSS) total score at baseline on whom ECT was not conducted (NECT group). Clinical and neuropsychological assessments were carried out at baseline before ECT treatment and at 2-year follow-up.
Significant differences were found between groups in the number of unsuccessful medication trials. No statistically significant differences were found between the ECT group and the NECT group in either severity as assessed by the PANSS, or in any cognitive variables at baseline. At follow-up, both groups showed significant improvement in clinical variables (subscales of positive, general, and total scores of PANSS and Clinical Global Impressions-Improvement). In the cognitive assessment at follow-up, significant improvement was found in both groups in the semantic category of verbal fluency task and digits forward. However, no significant differences were found between groups in any clinical or cognitive variable at follow-up. Repeated measures analysis found no significant interaction of time×group in any clinical or neuropsychological measures.
The current study showed no significant differences in change over time in clinical or neuropsychological variables between the ECT group and the NECT group at 2-year follow-up. Thus, ECT did not show any negative influence on long-term neuropsychological variables in our sample.
本研究旨在调查经诊断患有精神分裂症谱系障碍的青少年患者样本中,电休克治疗(ECT)的长期认知影响。
样本由9名青少年受试者组成,根据《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)标准诊断为精神分裂症或分裂情感性障碍,并接受了ECT治疗(ECT组),以及9名在年龄、社会经济地位、诊断和基线时的阳性与阴性症状量表(PANSS)总分相匹配的青少年受试者,他们未接受ECT治疗(非ECT组)。在ECT治疗前的基线以及2年随访时进行了临床和神经心理学评估。
在未成功的药物试验次数上,两组之间存在显著差异。在基线时,无论是通过PANSS评估的严重程度,还是任何认知变量,ECT组和非ECT组之间均未发现统计学上的显著差异。在随访时,两组在临床变量(PANSS的阳性、一般和总分分量表以及临床总体印象改善)方面均显示出显著改善。在随访时的认知评估中,两组在言语流畅性任务的语义类别和顺背数字方面均有显著改善。然而,在随访时,两组在任何临床或认知变量上均未发现显著差异。重复测量分析发现在任何临床或神经心理学测量中,时间×组间均无显著交互作用。
本研究表明,在2年随访时,ECT组和非ECT组在临床或神经心理学变量随时间的变化上没有显著差异。因此,在我们的样本中,ECT对长期神经心理学变量未显示出任何负面影响。