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改良电休克治疗老年难治性抑郁症的疗效与安全性

Efficacy and safety of modified electroconvulsive therapy for the refractory depression in older patients.

作者信息

Jiang Xue, Xie Qin, Liu Lian-Zhong, Zhong Bao-Liang, Si Liang, Fan Fang

机构信息

Psychiatric Intensive Care Unit (PICU), Wuhan Mental Health Center, Wuhan, Hubei, China.

Wuhan Mental Health Center, Wuhan, Hubei, China.

出版信息

Asia Pac Psychiatry. 2020 Dec;12(4):e12411. doi: 10.1111/appy.12411. Epub 2020 Aug 11.

Abstract

OBJECTIVE

We explored the clinical efficacy and safety of modified electroconvulsive therapy (ECT) in the treatment of elderly patients with refractory depression.

METHODS

A total of 43 older patients with refractory depression were enrolled in our study from March 2014 to February 2015, with the average age of 65 ± 4.8 years old. Modified electroconvulsive therapy (ECT) was performed in these patients after physical examinations and anesthesia procedures. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to assessing the efficacy of ECT, and Wechsler Memory Scale (WMS) and mini-mental state examination (MMSE) were used to evaluate the memory ability and cognitive function.

RESULTS

The rate of efficacy was calculated as 67.44% after 4 weeks of ECT treatment. Our results showed that HAMA and HAMD scores after 2 weeks of ECT treatment were significantly lower than pretreatment, and the differences were more significant after 4 weeks of ECT treatment. Compared with pretreatment, the scores of memory quotient and immediate memory of WMS decreased significantly after 1 week of treatment. However, these events were not be presented with the progress of treatment, except for after 2 weeks of treatment. Our results demonstrated that compared with pretreatment, the scores of MMSE significantly increased after 4 weeks of treatment.

CONCLUSION

ECT is an effective, well-tolerated, and safe method for the treatment of older patients with refractory depression. ECT can be recommended for the treatment of these patients after conducting effective risk control of comorbid somatic diseases.

摘要

目的

探讨改良电休克治疗(ECT)对老年难治性抑郁症患者的临床疗效及安全性。

方法

2014年3月至2015年2月共纳入43例老年难治性抑郁症患者,平均年龄65±4.8岁。对这些患者进行体格检查和麻醉后实施改良电休克治疗(ECT)。采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评估ECT疗效,采用韦氏记忆量表(WMS)和简易精神状态检查表(MMSE)评估记忆能力和认知功能。

结果

ECT治疗4周后的有效率为67.44%。结果显示,ECT治疗2周后的HAMA和HAMD评分显著低于治疗前,ECT治疗4周后差异更显著。与治疗前相比,治疗1周后WMS的记忆商数和即刻记忆评分显著下降。然而,除治疗2周后外,这些情况未随治疗进展而出现。结果表明,与治疗前相比,治疗4周后MMSE评分显著升高。

结论

ECT是治疗老年难治性抑郁症患者的一种有效、耐受性良好且安全的方法。在对合并躯体疾病进行有效风险控制后,可推荐ECT用于治疗这些患者。

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