Palma Miguel, Ferreira Berta, Borja-Santos Nuno, Trancas Bruno, Monteiro Céu, Cardoso Graça
Department of Psychiatry, Hospital Prof. Doutor Fernando Fonseca, EPE, 2720-276 Amadora, Portugal.
Day-Hospital, Lisbon Psychiatric Hospital Center, 1749-002 Lisbon, Portugal.
Depress Res Treat. 2016;2016:8306071. doi: 10.1155/2016/8306071. Epub 2016 Jan 5.
Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state.
引言。混合状态是双相情感障碍的常见表现形式，与对精神药理学治疗的较高抵抗性相关。仅有有限的证据支持在这些患者中使用电休克治疗（ECT）。我们旨在报告我们使用ECT治疗双相混合状态的经验。方法。收集了2006年6月至2011年6月期间所有接受急性ECT治疗的双相情感障碍患者的回顾性数据。根据发作的情感极性分为三组。使用临床总体印象量表（CGI）评分来确定临床缓解情况，并比较各组之间的人口统计学和临床变量。通过再次入院情况评估长期预后，同时考虑使用延续性或维持性ECT。结果。在研究时间段内，共对41例双相情感障碍患者进行了50个ECT疗程治疗。除了1例混合状态发作外，所有情感发作均显示出积极的临床反应。与抑郁发作的患者相比，处于混合状态的患者往往更年轻，首次住院时间更早。在ECT治疗次数、住院时间、转至延续性ECT治疗、再次入院次数以及下次再次入院时间方面未发现差异。结论。我们的结果支持ECT对处于混合情感状态患者的有效性。
