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每日强化电抽搐治疗 8 天对治疗抵抗性精神分裂症患者的阳性和阴性症状及一般精神病理的疗效:一项 4 周随访的初步研究

A Pilot Study on Daily Intensive ECT over 8 Days Improved Positive and Negative Symptoms and General Psychopathology of Patients with Treatment-Resistant Schizophrenia up to 4 Weeks after Treatment.

机构信息

Department of Psychiatry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Psychiatry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran,

出版信息

Neuropsychobiology. 2019;77(2):83-91. doi: 10.1159/000494698. Epub 2018 Nov 21.

DOI:10.1159/000494698
PMID:30463074
Abstract

OBJECTIVE

For patients with treatment-resistant schizophrenia (TRS) who do not respond to drug therapy, electroconvulsive therapy (ECT) is often employed as an additional treatment. The aims of the present study were to investigate to what extent an 8-day daily ECT treatment might reduce symptoms of schizophrenia among patients with TRS both in the short term (end of the treatment) and medium term, that is 4 and 12 weeks after the treatment.

METHODS

Fourteen patients with TRS based on DSM-5 criteria took part in the present study. ECT consisted of daily sessions for 8 consecutive days. At baseline, at the end of the intervention, and 4 and 12 weeks after study completion, trained psychiatrists assessed the patients' disease severity (positive and negative symptoms; psychopathology) and cognitive functions.

RESULTS

Disease symptoms (positive and negative symptoms; psychopathology) became reduced from baseline to the end of the intervention and to 4 weeks after treatment. Twelve weeks after the intervention symptoms again increased. Cognitive functions decreased from baseline to the end of the study and 4 weeks after treatment. However, by 12 weeks after the intervention, cognitive functions had returned to baseline levels.

CONCLUSION

The pattern of results suggests that an intensive 8-day daily course of ECT reduced psychiatric symptoms (positive and negative symptoms, psychopathology) in both the short and medium term among patients with TRS. The increase in symptoms between 4 and 12 weeks following intervention suggests that booster sessions of ECT could be beneficial.

摘要

目的

对于药物治疗无效的治疗抵抗性精神分裂症(TRS)患者,电休克疗法(ECT)通常作为附加治疗手段。本研究旨在探究为期 8 天的每日 ECT 治疗在短期(治疗结束时)和中期(治疗结束后 4 周和 12 周)对 TRS 患者的精神分裂症症状能在多大程度上有所缓解。

方法

本研究纳入了 14 名基于 DSM-5 标准的 TRS 患者。ECT 包括连续 8 天的每日治疗。在基线、干预结束时以及研究完成后 4 周和 12 周,训练有素的精神科医生评估了患者的疾病严重程度(阳性和阴性症状;精神病理学)和认知功能。

结果

疾病症状(阳性和阴性症状;精神病理学)从基线到干预结束以及治疗后 4 周都有所减轻。治疗后 12 周症状再次增加。认知功能从基线到研究结束以及治疗后 4 周都有所下降。然而,干预后 12 周,认知功能已恢复到基线水平。

结论

结果表明,强化的 8 天每日 ECT 治疗可在短期和中期内减轻 TRS 患者的精神症状(阳性和阴性症状、精神病理学)。治疗后 4 至 12 周之间症状的增加表明,ECT 的强化治疗可能会有获益。

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