Harvard Medical School, 25 Shattuck Street, Boston, MA, United States.
Harvard Medical School, 25 Shattuck Street, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, United States.
J Affect Disord. 2022 Feb 1;298(Pt A):256-261. doi: 10.1016/j.jad.2021.11.002. Epub 2021 Nov 4.
Electroconvulsive therapy (ECT) effectively treats depressive disorders, but many patients will have subsequent relapses. While some guidelines suggest prior response to ECT is an indication for ECT in a subsequent mood episode, it is unknown whether response to ECT is correlated between treatment courses. This study explores whether response to ECT at a first treatment correlates with response to treatment in a second independent ECT course.
Single-center retrospective cohort of patients receiving two different ECT treatment courses between 2011 and 2020 and who self-reported depression symptoms using the Quick Inventory of Depressive Symptomatology (QIDS) at baseline and following treatment #5.
286 patients received two independent ECT series during the study period, of whom 153 received at least 5 treatments in both series. Patients had similar QIDS scores at the start of each treatment series (Pearson's correlation, r = 0.58, p <0.001), but the change in QIDS following 5 ECT treatments was not correlated between series for individual patients (Pearson's correlation, r = 0.083, p = 0.31). In multivariate analyses, change in QIDS was similar for both treatment series, but patients were less likely to receive 5 treatments in the second treatment series.
retrospective cohort cannot control for factors influencing access to repeat ECT treatment CONCLUSIONS: While on average final QIDS score was the same following two independent treatment courses, for individual patients the change in depression symptoms was not correlated between treatment series. Further research is needed to identify factors that may predict longitudinal ECT response.
电抽搐治疗（ECT）有效地治疗抑郁症，但许多患者会随后复发。虽然一些指南建议先前对 ECT 的反应是随后情绪发作中进行 ECT 的指征，但尚不清楚 ECT 治疗之间的反应是否相关。本研究探讨了首次治疗中对 ECT 的反应是否与第二次独立 ECT 疗程中的治疗反应相关。
这是一项 2011 年至 2020 年间在单一中心接受两次不同 ECT 治疗的患者的回顾性队列研究，他们在基线和治疗后第 5 次时使用抑郁症状快速评定量表（QIDS）自我报告抑郁症状。
在研究期间，286 名患者接受了两次独立的 ECT 系列治疗，其中 153 名患者在两个系列中均接受了至少 5 次治疗。患者在每个治疗系列开始时的 QIDS 评分相似（皮尔逊相关，r=0.58，p<0.001），但患者在两个系列中 5 次 ECT 治疗后 QIDS 的变化无相关性（皮尔逊相关，r=0.083，p=0.31）。在多变量分析中，QIDS 的变化在两个治疗系列中相似，但患者在第二次治疗系列中接受 5 次治疗的可能性较小。
回顾性队列无法控制影响重复 ECT 治疗机会的因素。
虽然两次独立治疗后平均最终 QIDS 评分相同，但对于个体患者，两个治疗系列之间的抑郁症状变化无相关性。需要进一步研究以确定可能预测 ECT 纵向反应的因素。
