Concord Centre for Mental Health, Sydney Local Health District, Concord West, NSW, Australia.
Asia Pac Psychiatry. 2019 Dec;11(4):e12361. doi: 10.1111/appy.12361. Epub 2019 May 20.
There is a paucity of evidence regarding the use of electroconvulsive therapy (ECT) in the elderly with primary psychotic conditions, such as schizophrenia and schizoaffective disorder. This study examined the efficacy and safety of acute ECT treatment in late-life patients with primary psychotic conditions.
A retrospective chart review was conducted on all patients aged 60 and above, who received ECT within a large metropolitan psychiatric facility in Australia between 2012 and 2018, and who were diagnosed with a primary psychotic condition. Information regarding demographic data, illness correlates, ECT treatment, treatment outcomes, and adverse effects was collected.
A total of 20 patients met inclusion into the study, 35% of whom were diagnosed with schizophrenia and 65% with schizoaffective disorder. The average age was 69 years. Patients had been trialed on an average of seven distinct antipsychotic agents prior to acute ECT treatment; 50% had been trialed on clozapine. ECT was associated with full (60%) or partial remission (35%) of psychotic illness in 95% (n = 19) of patients. No ECT-related fatalities were encountered. Adverse effects were experienced in 20% of patients, although none precluded the continuation of treatment.
This study found ECT to be a highly effective and safe treatment in the elderly with schizophrenia and schizoaffective disorder, who had not responded adequately to psychotropic medications.
针对伴有原发性精神病（如精神分裂症和分裂情感障碍）的老年患者，电抽搐治疗（ECT）的应用证据有限。本研究旨在评估 ECT 治疗老年伴有原发性精神病患者的疗效和安全性。
对 2012 年至 2018 年期间在澳大利亚一家大型大都市精神病院接受 ECT 治疗且诊断为原发性精神病的所有 60 岁及以上患者进行回顾性图表审查。收集了人口统计学数据、疾病相关性、ECT 治疗、治疗结果和不良反应等信息。
共有 20 名患者符合纳入标准，其中 35%被诊断为精神分裂症，65%为分裂情感障碍。平均年龄为 69 岁。在接受急性 ECT 治疗之前，患者平均尝试过七种不同的抗精神病药物，其中 50%尝试过氯氮平。ECT 治疗后，95%（n=19）的患者精神病症状完全（60%）或部分缓解（35%）。未发生与 ECT 相关的死亡。20%的患者出现不良反应，但均未阻止治疗的继续进行。
本研究发现，ECT 治疗未对精神药物充分反应的老年精神分裂症和分裂情感障碍患者是一种非常有效且安全的治疗方法。
