Zhang Qing-E, Wang Zhi-Min, Sha Sha, Ng Chee H, Seiner Stephen J, Welch Charles A, Lok Grace K I, Chow Ines H I, Wang Fei, Li Lu, Xiang Yu-Tao
From the *The National Clinical Research Center for Mental Disorders, China & Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China; †Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; ‡Electroconvulsive Therapy Service, McLean Hospital, Belmont; §Harvard Medical School, Department of Psychiatry, Boston, MA; ∥Department of Education, Kiang Wu Nursing College of Macau; ¶Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
J ECT. 2016 Dec;32(4):251-255. doi: 10.1097/YCT.0000000000000327.
Little is known about the use of electroconvulsive therapy (ECT) for adolescent psychiatric patients in China. This study examined the frequency of ECT and the demographic and clinical correlates of adolescent psychiatric patients hospitalized in a tertiary psychiatric hospital in China.
This was a retrospective chart review of 954 inpatients aged between 13 and 17 years treated over a period of 8 years (2007-2013). Sociodemographic and clinical data were collected from the electronic chart management system for discharged patients.
The rate of ECT use was 42.6% in the whole sample (46.5% for patients with schizophrenia, 41.8% for major depressive disorder, 57.8% for bipolar disorders, and 23.9% for other diagnoses). Use of ECT was independently and positively associated with older age, high aggression risk at time of admission, and use of antipsychotics and antidepressants. Compared with patients with schizophrenia, those with other psychiatric diagnoses were less likely to receive ECT. The above significant correlates explained 32% of the variance of ECT use (P < 0.001). Limitations of this study included the lack of data regarding the efficacy and side effects of ECT. Furthermore, the high rate of ECT applied only to 1 setting which limits the ability to extrapolate the implications of the results to other populations.
The use of ECT was exceedingly high in adolescent patients treated in a tertiary clinical centre in China. It is unlikely that such a high rate of ECT use is found across China or that such practice reflects standard of care for psychiatrically ill adolescents. The underlying reasons for the high use of ECT at this center warrant urgent investigations.
在中国，关于青少年精神病患者使用电休克治疗（ECT）的情况鲜为人知。本研究调查了中国一家三级精神病医院收治的青少年精神病患者接受ECT治疗的频率以及相关的人口统计学和临床特征。
这是一项回顾性病历审查研究，对2007年至2013年8年间收治的954例年龄在13至17岁之间的住院患者进行了分析。从出院患者电子病历管理系统中收集社会人口统计学和临床数据。
整个样本中ECT的使用率为42.6%（精神分裂症患者为46.5%，重度抑郁症患者为41.8%，双相情感障碍患者为57.8%，其他诊断患者为23.9%）。ECT的使用与年龄较大、入院时攻击风险高以及使用抗精神病药物和抗抑郁药物独立且呈正相关。与精神分裂症患者相比，其他精神疾病诊断的患者接受ECT治疗的可能性较小。上述显著相关因素解释了ECT使用差异的32%（P < 0.001）。本研究的局限性包括缺乏关于ECT疗效和副作用的数据。此外，ECT的高使用率仅适用于一个机构，这限制了将结果外推至其他人群的能力。
在中国一家三级临床中心接受治疗的青少年患者中，ECT的使用率极高。在中国不太可能普遍存在如此高的ECT使用率，这种做法也不太可能反映对患有精神疾病的青少年的标准治疗。该中心ECT高使用率的潜在原因值得紧急调查。
