Academic Center for ECT and Neuromodulation (AcCENT), KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
Department of Medical Psychology, Neuropsychology Department, Amsterdam UMC location Academic Medical Center, Amsterdam, The Netherlands.
Acta Psychiatr Scand. 2020 Aug;142(2):132-140. doi: 10.1111/acps.13198. Epub 2020 Jun 19.
Although electroconvulsive therapy (ECT)-related anxiety is experienced by a significant proportion of patients, it remains understudied. Our aim was to study the course of ECT-related anxiety during ECT.
Seventy-four patients with unipolar or bipolar depression, referred for ECT, were included. ECT-related anxiety was assessed the morning before each ECT session using the ECT-related Anxiety Questionnaire (ERAQ).
Female patients reported more anxiety than men (F(1,64.6) = 3.95, P = 0.05). Patients with a psychotic depression were more anxious before the start of ECT (F(64.8) = 4.57, P = 0.04), but experienced a significant decrease in ECT-related anxiety (t(63.9) = -3.63, P = 0.0006), whereas patients with a non-psychotic depression remained stable on anxiety during their ECT course (t(63,9) = 0.76, P = 0.45). In addition, we found a significant correlation between the decrease of ECT-related anxiety and the decrease of depression-severity (r = 0.35; P = 0.04).
There are individual differences in ECT-related anxiety trajectories during ECT. Both female patients and patients with psychotic depression experienced more ECT-related anxiety before the start of ECT. The severity of ECT-related anxiety decreased significantly in patients with a psychotic depression, but remained stable in patients without a psychotic depression during ECT. In addition, patients who showed a stronger decrease in depression-severity also showed a stronger decrease in ECT-related anxiety. A better understanding of ECT-related anxiety trajectories can help in designing anxiety-reducing interventions.
尽管电休克治疗（ECT）相关焦虑症在很大比例的患者中存在，但对其研究仍然不足。我们的目的是研究 ECT 期间 ECT 相关焦虑的变化过程。
共纳入 74 例接受 ECT 治疗的单相或双相抑郁症患者。在每次 ECT 治疗前的早晨，使用 ECT 相关焦虑问卷（ECT-RAQ）评估 ECT 相关焦虑。
女性患者的焦虑程度高于男性（F（1，64.6）= 3.95，P = 0.05）。有精神病性抑郁症的患者在 ECT 开始前更为焦虑（F（64.8）= 4.57，P = 0.04），但 ECT 相关焦虑显著下降（t（63.9）= -3.63，P = 0.0006），而无精神病性抑郁症的患者在 ECT 期间的焦虑水平保持稳定（t（63.9）= 0.76，P = 0.45）。此外，我们发现 ECT 相关焦虑的下降与抑郁严重程度的下降之间存在显著相关性（r = 0.35；P = 0.04）。
ECT 期间 ECT 相关焦虑的轨迹存在个体差异。女性患者和有精神病性抑郁症的患者在 ECT 开始前均经历了更多的 ECT 相关焦虑。有精神病性抑郁症的患者 ECT 相关焦虑显著下降，而无精神病性抑郁症的患者在 ECT 期间保持稳定。此外，在抑郁严重程度下降较大的患者中，ECT 相关焦虑的下降也更为显著。更好地了解 ECT 相关焦虑的轨迹可以帮助设计减轻焦虑的干预措施。
