Carney Sarah, Sami Musa Basseer, Clark Victoria, Kuruvilla Kompancariel Kuruvilla
Kent and Medway NHS and Social Care Partnership Trust, Ashford, UK.
Kent and Medway NHS and Social Care Partnership Trust, Canterbury, UK.
BMJ Case Rep. 2015 May 24;2015:bcr2015209763. doi: 10.1136/bcr-2015-209763.
We describe the case of an 89-year-old woman (deceased) with a 60-year history of recurrent depressive disorder treated with electroconvulsive therapy (ECT). It is estimated that she received up to 400 ECTs over her life course as her symptoms would not respond to oral medication. Despite extensive exposure to ECT, there was only minimal cognitive impairment and an excellent safety record, even in later life, as she became increasingly frail from multiple comorbidities. Over the years, there has been a drive to reduce the frequency of ECT administration. However, this case illustrates how in some patients ECT may be vital for acute episodes of severe depression as well as for maintenance therapy. This case report adds to observational evidence that maintenance ECT may be an underused treatment for recurrent depression and also recommends that greater emphasis be given to incorporating carers' views when planning individualised treatment approaches.
我们描述了描述了一位89岁女性（已故）的病例，她患有复发性抑郁症60年，接受过电休克治疗（ECT）。据估计，她一生中接受了多达400次ECT治疗，因为她的症状对口服药物没有反应。尽管广泛接受ECT治疗，但即使在晚年，随着她因多种合并症而日益虚弱，她仅有轻微的认知障碍且安全性记录良好。多年来，一直有人致力于减少ECT的给药频率。然而，该病例表明，在某些患者中，ECT对于重度抑郁症的急性发作以及维持治疗可能至关重要。本病例报告补充了观察性证据，即维持性ECT可能是一种未得到充分利用的复发性抑郁症治疗方法，并且还建议在规划个体化治疗方案时，应更加重视纳入护理人员的意见。
