Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.
Department of Regional Studies and Humanities, Faculty of Education and Human Studies, Akita University, Akita, Japan.
Neuropsychopharmacol Rep. 2022 Dec;42(4):449-456. doi: 10.1002/npr2.12282. Epub 2022 Jul 22.
It is controversial whether psychotic features are a risk factor for relapse in patients with electroconvulsive therapy-responsive major depressive disorder. A recent study reported that benzodiazepine receptor agonists reduce relapse of psychotic depression. As long-term use of these agonists may induce dependence, further research is required. We examined whether psychotic features are associated with rehospitalization in electroconvulsive therapy-responsive major depressive disorder patients. We also investigated whether taking benzodiazepine receptor agonists at the end of electro-convulsive therapy was associated with rehospitalization among patients with psychotic depression.
This study included 47 hospitalized patients (22 with psychotic depression, 25 with non-psychotic depression) who had responded to electroconvulsive therapy. Rehospitalization for major depressive episodes within two years from the last session was investigated.
Twenty-three subjects (49%) were rehospitalized during the two-year follow-up. Kaplan-Meier analysis revealed no difference in rehospitalization between patients with psychotic and non-psychotic depression (Log-rank P = 0.87). Among the 22 responders to electroconvulsive therapy with psychotic depression, there was no difference in benzodiazepine receptor agonist use at the end of electroconvulsive therapy between the rehospitalization and non-rehospitalization groups.
Our exploratory study found no difference in the benzodiazepine receptor agonists use at the end of electroconvulsive therapy between rehospitalization and non-rehospitalization groups in patients with electroconvulsive therapy-responsive psychotic depression. Thus, the relapse-preventing effect of these agonists in psychotic depression should be investigated in future randomized controlled trials. Further research is also needed to determine whether psychotic features are associated with rehospitalization in these patients.
精神病性特征是否是电抽搐治疗反应性重度抑郁症患者复发的危险因素存在争议。最近的一项研究报告称，苯二氮䓬受体激动剂可降低精神病性抑郁症的复发率。由于这些激动剂的长期使用可能会导致依赖，因此需要进一步研究。我们检查了电抽搐治疗反应性重度抑郁症患者中精神病性特征是否与再入院相关。我们还调查了在电抽搐治疗结束时使用苯二氮䓬受体激动剂是否与精神病性抑郁症患者的再入院相关。
本研究纳入了 47 名住院患者（22 名患有精神病性抑郁症，25 名患有非精神病性抑郁症），他们对电抽搐治疗有反应。调查了从最后一次治疗结束后两年内因重度抑郁症发作而再次入院的情况。
在两年的随访中，有 23 名受试者（49%）再次入院。Kaplan-Meier 分析显示，精神病性和非精神病性抑郁症患者的再入院率无差异（对数秩 P=0.87）。在对电抽搐治疗有反应的 22 名精神病性抑郁症患者中，电抽搐治疗结束时使用苯二氮䓬受体激动剂在再入院组和非再入院组之间没有差异。
我们的探索性研究发现，电抽搐治疗反应性精神病性抑郁症患者中，再入院组和非再入院组在电抽搐治疗结束时使用苯二氮䓬受体激动剂之间没有差异。因此，这些激动剂在精神病性抑郁症中的预防复发作用应在未来的随机对照试验中进行研究。还需要进一步研究以确定精神病性特征是否与这些患者的再入院相关。
