From the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Istanbul University, İstanbul.
Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
J ECT. 2020 Mar;36(1):54-59. doi: 10.1097/YCT.0000000000000602.
The aim of this study was to report the efficacy and safety of electroconvulsive therapy (ECT) in manic, depressed, psychotic, and catatonic adolescent patients.
Medical records of 78 adolescents who had received ECT in Department of Psychiatry, Gaziantep University Medical Faculty, during 2011 to 2017 were reviewed. Sixty-two subjects in this sample were identified to have complete records and met the study inclusion criteria.
The mean ± SD age of subjects was 17.11 ± 1.04 years and female sex was 53.2% (n = 33). Primary the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnoses were bipolar mood disorders (n = 33, 53.2%), major depressive disorder (n = 16, 25.8%), schizophrenia (n = 8, 12.9%), and schizoaffective disorders (n = 5, 8.1%). Electroconvulsive therapy was significantly effective in treating manic, depressive, psychotic, and catatonia symptoms as evidenced by significant differences in pretreatment and posttreatment scores in outcome measures including Hamilton Depression Rating Scale, Young Mania Rating Scale, Positive and Negative Syndrome Scale, and Clinical Global Impression-Severity Scale (P < 0.001). Presence of comorbidity adversely affected treatment response (P = 0.001). However, ECT was also effective in those with comorbid diagnoses (P < 0.001). Depressive symptoms in patients with bipolar depression responded better than those with unipolar depression (P = 0.012). Electroconvulsive therapy was generally safe with subjective memory complaints (85%), headache (69%), and prolonged seizure (8%) as the reported adverse effects possibly related to ECT. Four subjects (6%) developed a manic switch during ECT.
Electroconvulsive therapy is an effective and a safe treatment option in adolescent patients with severe and resistant psychopathology. Although comorbidity may decrease treatment response, ECT seems to be effective even in the presence of multiple psychiatric diagnoses.
本研究旨在报告电抽搐治疗（ECT）在躁狂、抑郁、精神病和紧张症青少年患者中的疗效和安全性。
回顾了 2011 年至 2017 年期间在加济安泰普大学医学院精神病学部接受 ECT 的 78 名青少年的病历。在该样本中，有 62 名受试者有完整的记录并符合研究纳入标准。
受试者的平均年龄±标准差为 17.11±1.04 岁，女性占 53.2%（n=33）。主要的《精神障碍诊断与统计手册》第四版文字修订版或《精神障碍诊断与统计手册》第五版诊断为双相情感障碍（n=33，53.2%）、重性抑郁障碍（n=16，25.8%）、精神分裂症（n=8，12.9%）和分裂情感障碍（n=5，8.1%）。电抽搐治疗在治疗躁狂、抑郁、精神病和紧张症症状方面非常有效，这从治疗前后在包括汉密尔顿抑郁评定量表、杨氏躁狂评定量表、阳性和阴性症状量表和临床总体印象严重程度量表在内的结局测量中的评分显著差异中可以看出（P<0.001）。合并症的存在会对治疗反应产生不利影响（P=0.001）。然而，ECT 对合并诊断的患者也有效（P<0.001）。双相抑郁症患者的抑郁症状比单相抑郁症患者的反应更好（P=0.012）。电抽搐治疗通常是安全的，只有 8%的患者出现主观记忆主诉（85%）、头痛（69%）和延长的抽搐（8%）等不良反应，这些不良反应可能与 ECT 有关。4 名患者（6%）在 ECT 过程中出现躁狂转换。
电抽搐治疗是一种有效和安全的治疗选择，适用于患有严重和难治性精神病理学的青少年患者。尽管合并症可能会降低治疗反应，但即使存在多种精神诊断，ECT 似乎也是有效的。
