Yang Wei-Cheng, Lin Ching-Hua, Chen Cheng-Chung
From the Kaohsiung Municipal Kai-Syuan Psychiatric Hospital.
J ECT. 2020 Jun;36(2):106-110. doi: 10.1097/YCT.0000000000000619.
Major depressive disorder is a recurrent illness. Treatment strategies are generally focused on achieving remission and preventing relapse/recurrence. The aim of this study was to explore the risk factors associated with relapse for remitted patients during the 12-week follow-up.
This was an open-label trial for major depressive disorder patients receiving acute treatments with electroconvulsive therapy (ECT) and continuation medication in the 12-week follow-up. Symptom severity and psychosocial functioning were assessed using the 17-item Hamilton Rating Scale for Depression (HAMD-17) and the Work and Social Adjustment Scale at each visit. Remission was defined as a HAMD-17 of 7 or less after acute treatment. Relapse was defined as a HAMD-17 of 14 or greater. Subjects achieving remission after acute treatments were included for analysis. Survival analysis was used to investigate the factors associated with relapse.
Sixty patients receiving ECT for acute treatment were enrolled for 12-week follow-up. Using Cox regression analysis, a greater number of previous major depressive episodes and greater baseline Work and Social Adjustment Scale scores were significantly associated with shorter time to relapse.
The goal of acute treatment should focus on functional remission to prevent relapse. Further studies related to more effective treatments to prevent relapse after acute ECT are required in the future.
重度抑郁症是一种复发性疾病。治疗策略通常侧重于实现症状缓解并预防复发。本研究的目的是探讨缓解期患者在12周随访期间与复发相关的危险因素。
这是一项针对接受电休克治疗（ECT）急性治疗并在12周随访期间继续用药的重度抑郁症患者的开放标签试验。每次访视时使用17项汉密尔顿抑郁评定量表（HAMD-17）和工作与社会适应量表评估症状严重程度和社会心理功能。缓解定义为急性治疗后HAMD-17评分为7或更低。复发定义为HAMD-17评分为14或更高。纳入急性治疗后达到缓解的受试者进行分析。采用生存分析来研究与复发相关的因素。
60例接受ECT急性治疗的患者纳入12周随访。使用Cox回归分析，既往重度抑郁发作次数较多以及基线工作与社会适应量表得分较高与较短的复发时间显著相关。
急性治疗的目标应侧重于功能缓解以预防复发。未来需要开展更多关于预防急性ECT后复发的更有效治疗方法的研究。
