Obbels Jasmien, Gijsbregts Els, Verwijk Esmée, Verspecht Shauni, Lambrichts Simon, Vansteelandt Kristof, Sienaert Pascal
KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation (AcCENT), Kortenberg, Belgium.
Department of Psychiatry, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
Acta Psychiatr Scand. 2022 Dec;146(6):604-612. doi: 10.1111/acps.13496. Epub 2022 Sep 19.
Despite the established safety of electroconvulsive therapy (ECT), ECT-related anxiety (ERA) remains one of the most distressing complications of ECT. ERA is reported to diminish during an acute course of ECT, but it was never studied during maintenance ECT (M-ECT). Our aim was to study the trajectories of ERA during M-ECT and how they differ from trajectories during the acute course.
Thirty-nine patients with unipolar or bipolar depression, retained for M-ECT after an acute ECT course, were included. ERA was assessed the morning before each ECT session using the ECT-related Anxiety Questionnaire (ERAQ).
ERA remained stable during M-ECT (RC = -0.05 (SE = 0.06), t(8.35) = -0.86, p = 0.42), while ERA declined significantly during the acute course (RC = -0.85 (SE = 0.30), t(33.6) = -2.81, p = 0.0082). During the acute course, patients with a psychotic depression were more anxious at baseline (t(32)= -2.42, p = 0.02), and showed a significant decline in ERAQ scores (RC = -1.65 (SE = 0.46), t(31.6) = -3.56, p = 0.0012), whereas patients with a non-psychotic depression were less anxious at baseline and retained stable ERAQ scores during the acute course (RC = -0.06 (SE = 0.41), t(32.1) = -0.14, p = 0.89). Whereas a correlation (r = 0.48) was noticed between the decline of depression severity and ERA during the acute course, this was not the case during M-ECT.
ERA runs a stable course during M-ECT, after having decreased during the acute course. During the acute course, ERA trajectories differed significantly between patients with a psychotic and non-psychotic depression. Decline of depression severity and ERA are significantly connected during the acute course of ECT. Both depression severity and ERA remain stable during M-ECT.
尽管电休克治疗（ECT）已被证实具有安全性，但ECT相关焦虑（ERA）仍然是ECT最令人痛苦的并发症之一。据报道，ERA在ECT急性疗程中会减轻，但从未在维持性ECT（M-ECT）期间进行过研究。我们的目的是研究M-ECT期间ERA的变化轨迹，以及它们与急性疗程期间的轨迹有何不同。
纳入39例在急性ECT疗程后接受M-ECT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（ERAQ）评估ERA。
ERA在M-ECT期间保持稳定（回归系数（RC）=-0.05（标准误（SE）=0.06），t（8.35）=-0.86，p=0.42），而在急性疗程期间ERA显著下降（RC=-0.85（SE=0.30），t（33.6）=-2.81，p=0.0082）。在急性疗程中，患有精神病性抑郁症的患者在基线时更焦虑（t（32）=-2.42，p=0.02），并且ERAQ评分显著下降（RC=-1.65（SE=0.46），t（31.6）=-3.56，p=0.0012），而患有非精神病性抑郁症的患者在基线时焦虑程度较低，并且在急性疗程期间ERAQ评分保持稳定（RC=-0.06（SE=0.41），t（32.1）=-0.14，p=0.89）。虽然在急性疗程期间抑郁症严重程度的下降与ERA之间存在相关性（r=0.48），但在M-ECT期间并非如此。
ERA在急性疗程中下降后，在M-ECT期间保持稳定。在急性疗程中，患有精神病性和非精神病性抑郁症的患者之间ERA轨迹存在显著差异。在ECT急性疗程期间，抑郁症严重程度的下降与ERA显著相关。在M-ECT期间，抑郁症严重程度和ERA均保持稳定。
