在印度南部，电抽搐治疗后自我报告、自传和迷你精神状态检查定义的记忆缺陷的相关因素。

Correlates of self-reported, autobiographical, and mini-mental status examination defined memory deficits following electroconvulsive therapy in South India.

机构信息

Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, 16, De Crespigny Park, London, SE5 8AF, United Kingdom; South London and Maudsley NHS foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, BR3 3BX, United Kingdom; Department of Psychiatry, Christian Medical College, Vellore, 632002, India.

Department of Psychiatry, Christian Medical College, Vellore, 632002, India.

出版信息

Asian J Psychiatr. 2018 Apr;34:47-53. doi: 10.1016/j.ajp.2018.04.016. Epub 2018 Apr 3.

DOI:10.1016/j.ajp.2018.04.016

PMID:29635223

Abstract

BACKGROUND

Cognitive deficits, self-reported or found following electroconvulsive therapy (ECT), and their correlates are diverse. Despite the characteristics of people receiving ECT in Asia differ widely from the west, pertinent research from Asia remains sparse.

METHODS

We investigated the correlates of self-reported, mini-mental status examination (MMSE) defined, and autobiographical memory deficits in a cohort that received ECT in a south Indian tertiary-care setting. 76 consecutive consenting people were recruited within seven days of completing their ECT course. Memory was assessed by a subjective Likert scale, MMSE, and an autobiographical memory scale (AMS). Psychopathology was assessed by brief psychiatric rating scale, and serum cortisol levels were estimated by chemi-luminescence immunoassays. Relevant sociodemographic and clinical data were collected from the participants, and their medical records. The correlates were analysed using generalised linear models after adjusting for the effects of potential confounders.

RESULTS

Self-reported, MMSE-defined, and autobiographical memory deficits were present in 27.6% (95%CI 17.6-37.7%), 42.1% (95%CI 31.0-53.2%), and 36.8% (95%CI 26.0-47.7%) of participants, respectively. Agreement between the memory deficits was poor. Age, less education, duration of illness, hypothyroidism, and past history of another ECT course were significantly associated with MMSE-defined deficits. Age, anaemia, past ECT course, and pre-ECT blood pressure were significantly associated with autobiographical memory deficits, while residual psychopathology and cortisol levels were significantly associated with self-reported memory deficits.

CONCLUSION

Self-reported, MMSE-defined, and autobiographical memory deficits are common at the completion of ECT course, and their correlates differ. All service users receiving ECT need periodic cognitive assessments evaluating multiple cognitive domains.

摘要

背景

认知缺陷，无论是自我报告还是电抽搐治疗（ECT）后发现的，其相关性都多种多样。尽管亚洲接受 ECT 的人群特征与西方有很大的不同，但亚洲相关研究仍然很少。

方法

我们在印度南部的一家三级护理机构中，调查了接受 ECT 的患者中自我报告、简易精神状态检查（MMSE）定义和自传体记忆缺陷的相关性。在完成 ECT 疗程的七天内，连续招募了 76 名同意的患者。通过主观李克特量表、MMSE 和自传体记忆量表（AMS）评估记忆。使用简短精神病评定量表评估精神病理学，使用化学发光免疫分析估计血清皮质醇水平。从参与者及其病历中收集相关的社会人口统计学和临床数据。使用广义线性模型分析相关性，同时调整潜在混杂因素的影响。

结果

自我报告、MMSE 定义和自传体记忆缺陷分别在 27.6%（95%CI 17.6-37.7%）、42.1%（95%CI 31.0-53.2%）和 36.8%（95%CI 26.0-47.7%）的患者中存在。记忆缺陷之间的一致性较差。年龄较小、受教育程度较低、病程较长、甲状腺功能减退症和既往 ECT 疗程与 MMSE 定义的缺陷显著相关。年龄、贫血、既往 ECT 疗程和 ECT 前血压与自传体记忆缺陷显著相关，而残留的精神病理学和皮质醇水平与自我报告的记忆缺陷显著相关。