Professor of Psychiatry, Institute of Mental Health and NIHR MindTech MTEC, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, United Kingdom.
Professor/Director Methodology, Measurement and Statistical Analysis, Texas State University, Texas, US.
J Affect Disord. 2020 Dec 1;277:785-788. doi: 10.1016/j.jad.2020.09.006. Epub 2020 Sep 7.
Cranial electrotherapy stimulation (CES) is a safe and well-tolerated 6-12 week treatment that is clinically and cost effective on both anxiety and depression symptoms resulting in sustained remission of these symptoms at 12 and 24 weeks in generalized anxiety disorder (GAD) patients. The aim of the current report was to explore whether the effectiveness of CES was related to its effects on depression or anxiety over time METHODS: A consecutive sample of 161 eligible patients with GAD was recruited from two publicly funded services in England while they waited for individual cognitive behaviour therapy (CBT) after failing to achieve remission on the GAD-7 with computerised CBT. They received 60 minutes per day Alpha-Stim CES for 6-12 weeks. Outcomes were changes in PHQ-9, GAD-7 score from baseline to 4, 6, 8, 12 and 24 weeks. Latent variable cross-lagged panel analysis permitted an analysis of the differential effects of anxiety and depression with CES treatment over time.
Anxiety at baseline significantly predicted depression at week 4 (standardized regression weight = .40, p<0.001). Depression at week 12 significantly predicted anxiety at week 24 (standardized regression weight = .28, p<0.05).
Not a randomized controlled trial but further analysis of a prospective observational cohort. High rates of loss to follow up by 24 weeks.
Sustained effectiveness required a CES response to anxiety symptoms in first 4 weeks and improvement in depression symptoms by 12 weeks.
颅电刺激（CES）是一种安全且耐受良好的治疗方法，可在 6-12 周内有效治疗焦虑和抑郁症状，在广泛性焦虑障碍（GAD）患者中，可在 12 周和 24 周时持续缓解这些症状，并具有成本效益。本报告的目的是探讨 CES 的有效性是否与其随着时间的推移对抑郁或焦虑的影响有关。
在英格兰的两家公共资助服务机构中，连续招募了 161 名符合条件的 GAD 患者，这些患者在使用计算机化 CBT 未能使 GAD-7 缓解后，正在等待个体认知行为疗法（CBT）。他们每天接受 60 分钟的 Alpha-Stim CES 治疗，持续 6-12 周。结局为 PHQ-9、GAD-7 评分从基线到 4、6、8、12 和 24 周的变化。潜在变量交叉滞后面板分析允许分析 CES 治疗随时间对焦虑和抑郁的不同影响。
基线时的焦虑显著预测了第 4 周时的抑郁（标准化回归权重=0.40，p<0.001）。第 12 周的抑郁显著预测了第 24 周时的焦虑（标准化回归权重=0.28，p<0.05）。
这不是一项随机对照试验，而是对前瞻性观察队列的进一步分析。24 周时的随访丢失率很高。
持续有效的治疗需要 CES 在最初的 4 周内对焦虑症状有反应，并且在第 12 周时改善抑郁症状。
