Martin Donel M, Wong Ada, Kumar Divya R, Loo Colleen K
J ECT. 2018 Mar;34(1):21-25. doi: 10.1097/YCT.0000000000000455.
Assessment of post-electroconvulsive therapy (ECT) disorientation at a single time point after ECT treatment may prove an effective and clinically useful method for monitoring the severity of disorientation and predicting ECT-induced retrograde amnesia. In this study, we aimed to validate a novel instrument (10-Item Orientation Questionnaire) developed to assess the level of disorientation after ECT.
Twenty-four depressed inpatients who were prescribed an acute course of ECT were administered the 10-Item Orientation Questionnaire at 30 minutes after ECT and had time to reorientation assessed at 3 time points after ECT (10, 30, and 60 minutes) at ECT treatments 1 to 3. The association between average performance of the 10-Item Orientation Questionnaire across the acute ECT course and retrograde amnesia at post-ECT was examined using the Autobiographical Memory Interview-Short Form.
Mean performance on the 10-Item Orientation Questionnaire across treatments 1 to 3 was moderately correlated with average time to reorientation (r = -0.52, P = 0.02, n = 20). Across the acute ECT course, poorer performance on the 10-Item Orientation Questionnaire was associated with greater retrograde amnesia at post-ECT (r = 0.53, P = 0.03, n = 16).
The 10-Item Orientation Questionnaire when administered at 30 minutes after ECT is sensitive for detecting patients with slow recovery of orientation after ECT. Use of this instrument therefore has potential for improving routine patient monitoring in clinical practice and identifying patients at increased risk of retrograde memory adverse effects following treatment.
在电休克治疗(ECT)后单个时间点评估ECT后定向障碍,可能是监测定向障碍严重程度及预测ECT所致逆行性遗忘的一种有效且具有临床实用性的方法。在本研究中,我们旨在验证一种新开发的用于评估ECT后定向障碍水平的工具(10项定向问卷)。
对24例接受ECT急性疗程治疗的抑郁症住院患者,在ECT后30分钟进行10项定向问卷测试,并在ECT治疗1至3次后的3个时间点(10、30和60分钟)评估其重新定向的时间。使用自传体记忆访谈简表,研究急性ECT疗程中10项定向问卷的平均表现与ECT后逆行性遗忘之间的关联。
治疗1至3次期间,10项定向问卷的平均表现与重新定向的平均时间呈中度相关(r = -0.52,P = 0.02,n = 20)。在急性ECT疗程中,10项定向问卷表现较差与ECT后更严重的逆行性遗忘相关(r = 0.53,P = 0.03,n = 16)。
ECT后30分钟进行10项定向问卷测试,对于检测ECT后定向恢复缓慢的患者很敏感。因此,使用该工具有可能改善临床实践中的常规患者监测,并识别治疗后发生逆行性记忆不良反应风险增加的患者。