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电抽搐治疗在青少年精神分裂谱系障碍中的长期疗效。

Long-term effectiveness of electroconvulsive therapy in adolescents with schizophrenia spectrum disorders.

机构信息

Department of Child and Adolescent Psychiatry and Psychology, SGR1119, Institut Clinic de Neurociències, Hospital Clínic Universitari de Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain,

出版信息

Eur Child Adolesc Psychiatry. 2015 May;24(5):517-24. doi: 10.1007/s00787-014-0602-3. Epub 2014 Sep 3.

Abstract

To compare a sample of adolescents with schizophrenia spectrum disorders (SSD) treated with either ECT or antipsychotics (AP) alone at long-term follow-up. Patients diagnosed with SSD (n = 21) treated with ECT due to resistance to AP or catatonia under the age of 18 years (ECT group), were compared to a randomly selected group of patients with SSD treated only with AP (non-ECT group) (n = 21) and matched for age, gender, diagnosis and duration of illness. Baseline data were gathered retrospectively from medical records. Subjects were assessed at follow-up (mean of follow-up period = 5.5 years; range 2-9 years) using several clinical scales such as the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression Scale (CGI) and the Global Assessment of Functioning (GAF). Improvement in PANSS positive, negative, general, total and CGI and GAF scores between baseline and follow-up assessment did not differ significantly between groups. At follow-up, no differences were observed for the PANSS negative, CGI and GAF scores between groups, but patients in the ECT group still had higher PANSS total, positive and general scores. ECT treatment followed by AP medication in treatment-resistant SSD or catatonia is at least as effective in the long term as AP alone in non-resistant patients.

摘要

比较一组精神分裂症谱系障碍(SSD)青少年患者在长期随访中的治疗效果,一组接受电抽搐治疗(ECT)联合抗精神病药物(AP),另一组单独使用 AP 治疗。将因对 AP 耐药或出现紧张性木僵而接受 ECT 治疗的年龄在 18 岁以下的 SSD 患者(ECT 组)与仅接受 AP 治疗的随机选择的 SSD 患者(非 ECT 组)(n=21)进行比较,这两组患者在年龄、性别、诊断和病程方面相匹配。从病历中回顾性收集基线数据。在随访时(平均随访期为 5.5 年;范围 2-9 年),使用阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)和总体功能评估(GAF)等临床量表对受试者进行评估。与基线评估相比,PANSS 阳性、阴性、一般、总分和 CGI 以及 GAF 评分在组间的改善无显著差异。在随访时,组间 PANSS 阴性、CGI 和 GAF 评分无差异,但 ECT 组的患者仍有更高的 PANSS 总分、阳性和一般评分。对于耐药性 SSD 或紧张性木僵患者,在 AP 药物治疗基础上联合 ECT 治疗与单独使用 AP 治疗在长期疗效上至少相当。

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