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精神分裂症住院患者电抽搐治疗后认知改善的回顾性研究。

A Retrospective Study of Cognitive Improvement Following Electroconvulsive Therapy in Schizophrenia Inpatients.

机构信息

From the Research Division.

Department of General Psychiatry, Institute of Mental Health, Singapore.

出版信息

J ECT. 2019 Sep;35(3):170-177. doi: 10.1097/YCT.0000000000000569.

Abstract

OBJECTIVES

Findings on the cognitive effect of electroconvulsive therapy (ECT) in individuals with schizophrenia have brought mixed results, with few recent studies beginning to report cognitive improvements after treatment. Cognitive change in inpatients with schizophrenia who were referred for an acute course of ECT was examined in the current study. Furthermore, the study aimed to determine the profile of patients who experience cognitive improvement and the potential use of a brief cognitive battery to detect this positive cognitive change, if any.

METHODS

Montreal Cognitive Assessment (MoCA) was conducted at baseline and posttreatment after 6 sessions of ECT. The Brief ECT Cognitive Screen was also administered to determine its predictive ability on cognitive gain of 2 points or higher in MoCA total scores for the 2 consecutive time points.

RESULTS

A total of 81 inpatients were included in the study. Retrospective analysis revealed significant improvements in MoCA total score and domains of visuospatial/executive function and attention. Cognitive improvement was more pronounced among those who had worse pre-MoCA score before ECT.

CONCLUSIONS

The study provided support to the existing literature where cognitive improvement has been reported among individuals with schizophrenia after ECT. Future studies should consider the use of randomized controlled trials to examine the possible cognitive benefits of ECT. In a setting where there is a high volume of patients receiving ECT, the monitoring of patients' cognitive status through the course of ECT continues to be warranted and the Brief ECT Cognitive Screen may be useful as a quick measure to detect such ECT-related cognitive change.

摘要

目的

电痉挛疗法(ECT)对精神分裂症个体认知影响的研究结果喜忧参半,最近鲜有研究开始报告治疗后的认知改善。本研究旨在检查接受急性 ECT 治疗的精神分裂症住院患者的认知变化,并确定经历认知改善的患者特征,以及是否可以使用简短认知测试来检测任何潜在的认知改善。

方法

在基线和 ECT 治疗后 6 个疗程后进行蒙特利尔认知评估(MoCA)。还进行了简短 ECT 认知筛查,以确定其在 MoCA 总分提高 2 分或更高的认知增益方面的预测能力,该认知增益在连续两个时间点上进行评估。

结果

共有 81 名住院患者纳入研究。回顾性分析显示 MoCA 总分以及视空间/执行功能和注意力领域的显著改善。ECT 前 MoCA 评分较差的患者认知改善更为明显。

结论

该研究为现有的文献提供了支持,即 ECT 后精神分裂症个体的认知得到改善。未来的研究应考虑使用随机对照试验来检查 ECT 可能带来的认知益处。在需要大量患者接受 ECT 的环境中,在 ECT 过程中持续监测患者的认知状态仍然是必要的,简短 ECT 认知筛查可能是一种有用的快速检测 ECT 相关认知变化的方法。

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