Antosik-Wójcińska Anna, Święcicki Łukasz
Oddział Chorób Afektywnych IPiN w Warszawie.
Psychiatr Pol. 2016 Oct 31;50(5):1015-1026. doi: 10.12740/PP/59104.
The aim of the study was to evaluate efficacy and safety of electroconvulsive therapy (ECT), in two age groups: before and after 60 years of age.
The study included 107 patients, 62 women and 45 men hospitalized in the Institute of Psychiatry and Neurology and treated with ECT in 2013 and 2014. 76 people were below 60 years; 31 people - above 60. The authors analyzed the course of 1086 ECTs, 747 sessions for patients before 60 and 339 in patients over 60 years of age. The efficacy of ECT was diagnosed using CGI Scale.
No serious complications such as death, life-threatening condition, hospitalization in another ward or permanent injury occurred. In 67.11% of patients below 60 and 42% of patients after 60 years of age no side effects were observed. Below 60 years of age most frequently reported adverse reactions were headaches (13.16% of patients), above 60 years of age - memory impairment (22.58% of respondents). Arrhythmias occurred in 6 patients aged over 60. Disturbances of consciousness occurred among older patients slightly less frequently than in younger patients (3.25% vs. 3.95%). In patients over 60 years of age remission rate was similar as in younger age group (32.89% vs 32.26%) and significant improvement rate was even higher (61.29% over 60 vs. 48.68 before 60 years of age). No improvement of mental state occurred in 7.89% and worsening occurred in 2.63% of younger patients. All patients ged over 60 years benefited from the treatment.
The effectiveness of ECT in elderly was similar as in younger age group. The tolerance was slightly worse in patients aged over 60 years than in younger patients. The biggest problem in the elderly was not cognitive impairment, but the cardiovascular complications.
本研究旨在评估电休克治疗（ECT）在两个年龄组（60岁之前和之后）中的疗效和安全性。
该研究纳入了107例患者，其中62例女性和45例男性，于2013年和2014年在精神病学与神经病学研究所住院并接受ECT治疗。76人年龄在60岁以下；31人年龄在60岁以上。作者分析了1086次ECT治疗过程，60岁之前的患者有747次治疗，60岁以上的患者有339次治疗。使用CGI量表诊断ECT的疗效。
未发生严重并发症，如死亡、危及生命的情况、转至其他病房住院或永久性损伤。60岁以下的患者中67.11%以及60岁以上的患者中42%未观察到副作用。60岁以下最常报告的不良反应是头痛（13.16%的患者），60岁以上是记忆障碍（22.58%的受访者）。6例60岁以上的患者发生心律失常。老年患者意识障碍的发生率略低于年轻患者（3.25%对3.95%）。60岁以上患者缓解率与年轻组相似（32.89%对32.26%），显著改善率甚至更高（60岁以上为61.29%，60岁之前为48.68%）。7.89%的年轻患者精神状态无改善，2.63%的年轻患者病情恶化。所有60岁以上的患者均从治疗中获益。
ECT在老年人中的有效性与年轻组相似。60岁以上患者的耐受性略低于年轻患者。老年人最大的问题不是认知障碍，而是心血管并发症。
