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电抽搐治疗老年患者:印度北部三级护理中心的一项研究。

Electroconvulsive Therapy among Elderly patients: A study from Tertiary care centre in north India.

机构信息

Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India.

Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India.

出版信息

Asian J Psychiatr. 2018 Jan;31:43-48. doi: 10.1016/j.ajp.2018.01.004. Epub 2018 Jan 31.

Abstract

OBJECTIVE

This retrospective study aimed to evaluate the effectiveness and safety of ECT among elderly patients receiving electroconvulsive therapy (ECT).

METHODS

During the study period of January 2008 to May 2017, 151 patients aged ≥60 years received ECT and they formed the study sample. Data on patients aged 19 to 59 years for the period of 3 years (2014-2016) was also extracted for comparison purposes.

RESULTS

The mean age of the elderly subjects was 65.8 years. In contrast to the young patients, elderly patients who received ECT more often had diagnosis of affective disorder, especially unipolar depression. Compared to young patients, elderly patients had higher prevalence of physical comorbidity with one third having more than one physical illness. The most common reason for use of ECT among elderly was poor response to medications (62.3%), followed by requirement of early response (49.6%). Four-fifth (80.8%) of the elderly patients showed ≥50% reduction in the symptoms with ECT. In terms of side effects, acute blood pressure changes were seen in 40.3% of patients during the ECT procedure and about half of the patients reported cognitive disturbances.

CONCLUSION

Present study suggests that ECT can be safely used among elderly patients, especially those with depressive disorders, not responding to medications.

摘要

目的

本回顾性研究旨在评估电抽搐治疗(ECT)中≥60 岁老年患者的有效性和安全性。

方法

在 2008 年 1 月至 2017 年 5 月期间,共有 151 名年龄≥60 岁的患者接受了 ECT,他们构成了研究样本。还提取了同期(2014-2016 年)年龄为 19-59 岁的患者的 3 年数据作为对照。

结果

老年患者的平均年龄为 65.8 岁。与年轻患者相比,接受 ECT 的老年患者更常被诊断为情感障碍,特别是单相抑郁症。与年轻患者相比,老年患者的躯体合并症更为常见,三分之一的患者有超过一种的躯体疾病。老年患者接受 ECT 的最常见原因是药物治疗反应不佳(62.3%),其次是需要早期反应(49.6%)。五分之四(80.8%)的老年患者在接受 ECT 后症状减轻≥50%。在副作用方面,40.3%的患者在 ECT 过程中出现急性血压变化,约一半的患者报告出现认知障碍。

结论

本研究表明,ECT 可安全用于老年患者,特别是那些对药物治疗反应不佳的抑郁障碍患者。

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