Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.
Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
Nord J Psychiatry. 2023 Aug;77(6):560-565. doi: 10.1080/08039488.2023.2189300. Epub 2023 Mar 16.
Electroencephalography (EEG) is used in psychiatric services, however, clinical guidelines do not clearly state when EEG is indicated, and its diagnostic value in psychiatric settings is unclear. We aimed to characterize the clinical use and diagnostic consequences of EEG in a general psychiatric setting to evaluate and optimize its use.
We performed a quality development project at the psychiatric services of the Central Denmark Region. We identified patients referred for EEG examination from psychiatric services between 1 September 2017 and 1 September 2022. We extracted data from electronic health records on patient characteristics, indications, EEG results, and treatment consequences and analyzed risk factors for abnormal EEGs.
Among 57,031 persons seen in the psychiatric services in the study period, 219 (0.4%) were referred for EEG examination. Psychosis ( = 70, 32%) was the most common symptom and suspicion of epilepsy ( = 129, 59%) was the most common clinical suspicion leading to referral. Of the 219 patients, 53 (24%) had an abnormal EEG result including 17 (7.8%) with epileptiform changes. Abnormal EEGs led to treatment alterations in six patients (3%). Age, prior epilepsy, use of antiseizure medication, use of clozapine, and convulsions were associated with epileptiform changes in the EEG.
EEG is rarely used in psychiatric settings and seldom has treatment consequences. However, in specific clinical settings, the EEG result leads to an alteration of clinical management and the findings, therefore, call for refinement of clinical guidelines to optimize the use of EEG.
脑电图（EEG）用于精神科服务，但临床指南并未明确说明何时需要进行 EEG，其在精神科环境中的诊断价值也不清楚。我们旨在描述一般精神科环境中 EEG 的临床应用和诊断结果，以评估和优化其使用。
我们在丹麦中部地区的精神科服务中进行了一项质量发展项目。我们从 2017 年 9 月 1 日至 2022 年 9 月 1 日期间从精神科服务中识别出接受 EEG 检查的患者。我们从电子健康记录中提取患者特征、指征、EEG 结果和治疗结果的数据，并分析 EEG 异常的危险因素。
在研究期间接受精神科服务的 57031 人中，有 219 人（0.4%）被转介进行 EEG 检查。精神病（ = 70，32%）是最常见的症状，疑似癫痫（ = 129，59%）是导致转介的最常见临床怀疑。在 219 名患者中，53 名（24%）的 EEG 结果异常，包括 17 名（7.8%）有癫痫样改变。异常 EEG 导致 6 名患者（3%）的治疗改变。年龄、既往癫痫、抗癫痫药物使用、氯氮平使用和抽搐与 EEG 中的癫痫样改变相关。
EEG 在精神科环境中很少使用，很少有治疗后果。然而，在特定的临床环境中，EEG 结果会导致临床管理的改变，因此需要完善临床指南以优化 EEG 的使用。
