Hausmann Armand, Post Thomas, Post Fabienne, Dehning Julia, Kemmler Georg, Grunze Heinz
J ECT. 2019 Jun;35(2):122-126. doi: 10.1097/YCT.0000000000000547.
The aim of the study was to contribute evidence for the efficacy of continuation and maintenance electroconvulsive therapy (c/mECT) going beyond the existing literature by examining longer-term outcomes from a single center.
We conducted a retrospective observational cohort study for a 14-year period, in which a group of 27 individuals with mood disorders, as defined by International Classification of Diseases-10, were examined and received acute ECT, followed by c/mECT. Mirror-image comparison of individual data sets, 5 years before and after c/mECT, was conducted for the number and mean duration of hospitalizations, as well as inpatient days per year. Statistical analysis was performed using general equation estimation modeling.
In 27 patients (63% female, mean ± SD age = 54.3 ± 11.7 years) experiencing either from bipolar (41%) or unipolar (59%) mood disorder, with most patients presenting with a depressive episode at hospital admission (93%), c/mECT was initiated after a successful course of acute ECT in addition to treatment as usual. In a 5-year period before and after starting c/mECT, we observed a significant decline in the mean number of hospitalizations per year (0.64 vs 0.32, P = 0.031), the average number of inpatient days per year (23.7 vs 6.1 days, P < 0.001), and the mean duration of hospital stays (41.6 vs 22.1 days, P = 0.031).
The findings provide further support for the efficacy of c/mECT as an augmentation therapy to psychopharmacological treatment in patients experiencing mood disorders, who have responded to acute ECT. Further studies, however, using a controlled study design and larger sample sizes are needed.
本研究旨在通过考察单中心的长期结果，为延续性和维持性电休克治疗（c/mECT）的疗效提供超越现有文献的证据。
我们进行了一项为期14年的回顾性观察队列研究，对一组27名符合《国际疾病分类第10版》定义的情绪障碍患者进行检查并给予急性电休克治疗，随后进行c/mECT。对c/mECT前后5年的个体数据集进行镜像比较，比较住院次数、平均住院时长以及每年的住院天数。使用一般方程估计模型进行统计分析。
27例患者（63%为女性，平均年龄±标准差=54.3±11.7岁）患有双相（41%）或单相（59%）情绪障碍，大多数患者入院时表现为抑郁发作（93%），除常规治疗外，在急性电休克治疗成功后开始c/mECT。在开始c/mECT前后的5年期间，我们观察到每年的平均住院次数显著下降（0.64对0.32，P = 0.031），每年的平均住院天数显著下降（23.7对6.1天，P < 0.001），平均住院时长显著下降（41.6对22.1天，P = 0.031）。
这些发现进一步支持了c/mECT作为对急性电休克治疗有反应的情绪障碍患者心理药物治疗增强疗法的疗效。然而，需要进一步采用对照研究设计和更大样本量的研究。
