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儿童及青少年电休克治疗的随访研究

A Follow-up Study of Electroconvulsive Therapy in Children and Adolescents.

作者信息

Mitchell Shanti, Hassan Ehmer, Ghaziuddin Neera

出版信息

J ECT. 2018 Mar;34(1):40-44. doi: 10.1097/YCT.0000000000000452.

Abstract

OBJECTIVES

Electroconvulsive therapy (ECT) is an effective and a safe treatment for several severe psychiatric disorders across the age span. However, its use remains controversial and highly stigmatized especially among patients under 18 years. In this study, we examined current symptoms, attitudes, perception, and functioning of patients treated with ECT when they were less than 18 years old.

METHODS

Participants had received ECT before age 18, between 1989 and 2015, at a tertiary medical center. Institutional review board-approval was obtained, and study documents (cover letter, consent, self-ratings scales for depression, anxiety, global functioning, and suicidality) were mailed.

RESULTS

Based on self-rated depression, 59.1% (13/22) participants indicated mild or no depression; 65% (13/20) reported mild or no anxiety; the majority, 84.3% (16/19) perceived ECT as having improved their overall illness; and 27.3% (6/22) among the respondents reported no clinical impairment on a global functioning scale, whereas 72.7% (16/22) reported significant or severe impairment. Despite reports of ongoing impaired global functioning among some participants, adequate academic performance (83.3%, 5/6) and mild or no suicidality (78.3%, 18/23) were endorsed by the majority reported.

CONCLUSIONS

The majority of participants who had received ECT before age 18 years reported mild or absence of depression and anxiety on self-rated follow-up measures after treatment with ECT. Most notably, the majority reported absence of suicidality and adequate academic performance. A number of respondents, however, continued to endorse global impairment, which may be a reflection of their baseline severe illness, which had warranted treatment with ECT.

摘要

目的

电休克治疗(ECT)是一种针对各年龄段多种严重精神疾病的有效且安全的治疗方法。然而,其应用仍存在争议,且备受污名化,尤其是在18岁以下的患者中。在本研究中,我们调查了18岁以下接受ECT治疗的患者当前的症状、态度、认知及功能状况。

方法

参与者于1989年至2015年期间在一家三级医疗中心接受18岁之前的ECT治疗。获得了机构审查委员会的批准,并邮寄了研究文件(附信、同意书、抑郁、焦虑、整体功能及自杀倾向自评量表)。

结果

根据自评抑郁情况,59.1%(13/22)的参与者表示有轻度抑郁或无抑郁;65%(13/20)报告有轻度焦虑或无焦虑;大多数人,84.3%(16/19)认为ECT改善了他们的整体病情;27.3%(6/22)的受访者在整体功能量表上报告无临床功能损害,而72.7%(16/22)报告有显著或严重损害。尽管一些参与者报告持续存在整体功能受损,但大多数人报告学业表现良好(83.3%,5/6)且有轻度自杀倾向或无自杀倾向(78.3%,18/23)。

结论

大多数在18岁之前接受ECT治疗的参与者在ECT治疗后的自评随访中报告有轻度抑郁或无抑郁、焦虑。最值得注意的是,大多数人报告无自杀倾向且学业表现良好。然而,一些受访者仍认可整体功能受损,这可能反映了他们需要ECT治疗的基线重症病情。

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