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[维持性电休克治疗在心境障碍中的应用价值]

[The interest of maintenance electroconvulsive therapy in mood disorders].

作者信息

Zaki H, Sentissi O, Olié J-P, Lôo H, Mouaffak F, Gaillard R

机构信息

Service hospitalo-universitaire de santé mentale et de thérapeutique, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 7, rue Cabanis, 75674 Paris cedex 14, France.

出版信息

Encephale. 2013 Oct;39(5):367-73. doi: 10.1016/j.encep.2012.06.010. Epub 2013 Jan 11.

Abstract

Maintenance electroconvulsive therapy (M-ECT) is a treatment indicated for the treatment and prevention of recurrent depression in patients who either do not respond or do not tolerate psychotropic medication. We evaluated, retrospectively, clinical response to a 6-month minimum course of M-ECT in 25 patients with a diagnosis of bipolar disorder or schizoaffective disorder according to DSM IV-TR criterion. Our study demonstrated a significant improvement of Global Assessment of functioning (GAF) scores after a six month minimum course of M-ECT (34.8 ± 12.6 vs 65.6 ± 10.8; P<0.05) as well as Brief Psychiatric Rating Scale scores (BPRS): 79.3 ± 12.4 vs 43.4 ± 10.2; P<0.05). We observed a slight increase of Mini Mental State Examination (MMSE) scores after M-ECT; nonetheless, it was not statistically significant (24.2 ± 2.4 vs 26.2 ± 2.4; P=0.2). Regarding the mean duration of hospitalizations, we showed a statistically significant decrease in the median number of days of hospitalization (72 [59-93.50] days before M-ECT vs 43 [25-76] days since the first M-ECT; P=0.017). Maintenance ECT allowed a significant improvement in psychiatric symptoms and global functioning of the patients included in this study, as well as a decrease in the number of days of hospitalization. However, our pattern is limited because of its small size; so, further prospective studies in this field, including larger population is highly recommended.

摘要

维持性电休克治疗(M-ECT)是一种用于治疗和预防对精神药物无反应或不耐受的患者复发性抑郁症的治疗方法。我们根据DSM IV-TR标准,对25例诊断为双相情感障碍或精神分裂症的患者进行了回顾性评估,观察他们在接受至少6个月的M-ECT治疗后的临床反应。我们的研究表明,在接受至少6个月的M-ECT治疗后,功能总体评定量表(GAF)评分有显著改善(34.8±12.6 vs 65.6±10.8;P<0.05),简明精神病评定量表(BPRS)评分也有显著改善:79.3±12.4 vs 43.4±10.2;P<0.05。我们观察到M-ECT治疗后简易精神状态检查表(MMSE)评分略有增加;然而,差异无统计学意义(24.2±2.4 vs 26.2±2.4;P=0.2)。关于住院时间的中位数,我们发现住院天数有统计学意义的减少(M-ECT治疗前为72[59-93.50]天,自首次M-ECT治疗后为43[25-76]天;P=0.017)。维持性电休克治疗使本研究中的患者精神症状和整体功能有显著改善,同时住院天数减少。然而,由于本研究样本量小,其结论有限;因此,强烈建议在该领域开展进一步的前瞻性研究,纳入更多的人群。

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