Maoz Hagai, Nitzan Uri, Goldwyn Yiftach, Krieger Israel, Bloch Yuval
J ECT. 2018 Jun;34(2):104-107. doi: 10.1097/YCT.0000000000000469.
There is a dearth of up-to-date literature regarding electroconvulsive therapy (ECT) in adolescents, and the question of when to pronounce course failure has not been properly addressed. The current study aims to evaluate trajectories of clinical status throughout ECT courses in adolescent patients.
We retrieved detailed data of 36 patients who received ECT in our treatment center. Clinical records were retrospectively assessed and evaluated every 6 ECT sessions to quantify Clinical Global Impressions-Improvement (CGI-I) scores.
The mean number of sessions per course was 24.4 ± 14.2. The mean CGI-I score at the conclusion of the ECT courses was 2.47 ± 1.19. At the end of the acute treatment stage, 26 patients (72.2%) were much or very much improved, based on CGI-I scores. Only 5 patients exhibited a significant response after 6 sessions or fewer, whereas 21 patients (56.6%) improved after 12 sessions. Pearson correlations between CGI-I scores throughout the course of ECT showed no significant correlation between CGI-I scores after 6 sessions and the final CGI-I scores. However, a significant correlation was found between CGI-I scores after 12 sessions and the final CGI-I score.
An improvement in the clinical status of adolescents treated by ECT might occur only after a substantial number of sessions. An early lack of response does not necessarily predict a failed ECT course.
关于青少年电休克治疗（ECT）的最新文献匮乏，何时判定疗程失败的问题尚未得到妥善解决。本研究旨在评估青少年患者在整个ECT疗程中的临床状态轨迹。
我们检索了在我们治疗中心接受ECT治疗的36例患者的详细数据。对临床记录进行回顾性评估，并每6次ECT治疗后进行评估，以量化临床总体印象改善（CGI-I）评分。
每个疗程的平均治疗次数为24.4±14.2次。ECT疗程结束时的平均CGI-I评分为2.47±1.19。在急性治疗阶段结束时，根据CGI-I评分，26例患者（72.2%）有很大或非常大的改善。只有5例患者在6次或更少次数的治疗后出现显著反应，而21例患者（56.6%）在12次治疗后有所改善。整个ECT疗程中CGI-I评分之间的Pearson相关性显示，6次治疗后的CGI-I评分与最终CGI-I评分之间无显著相关性。然而，发现12次治疗后的CGI-I评分与最终CGI-I评分之间存在显著相关性。
青少年接受ECT治疗后的临床状态改善可能仅在大量治疗后才会出现。早期无反应不一定预示ECT疗程失败。
