de Mangoux Gonzague Corbin, Amad Ali, Quilès Clélia, Schürhoff Franck, Pignon Baptiste
GHU Paris psychiatrie et neurosciences, Site Sainte-Anne, Service de psychiatrie adultes 17 and 18, Pôle 16, Université de Paris, 1 Rue Cabanis, 75014 Paris, France.
University of Lille, Inserm, CHU Lille, U1172, LilNcog, Lille Neuroscience and Cognition, F-59000 Lille, France.
Schizophr Bull Open. 2022 Aug 24;3(1):sgac053. doi: 10.1093/schizbullopen/sgac053. eCollection 2022 Jan.
Eighty years ago, schizophrenia was the first indication for electroconulsive therapy (ECT), and likewise ECT was one of the first treatments used for schizophrenia. This paper presents the history of ECT in the treatment of schizophrenia and its evolution, from it's discovery in the 20th century, which is an example of empiricism with a sequence of "" therapies. Following this discovery, the use ECT in schizophrenia has been in expansion during several decades, in a context of lack of efficacy of the treatment in schizophrenia. Then, after World War II and the derivative use of ECT in Germany, the use of ECT has decline during several decades. However, in the last decades, the use of ECT in schizophrenia has reemerged. Indeed, among patients in schizophrenia, rates of resistance to treatment have always been and still are high. In 2017, the concept of "" was defined when clozapine was tried and failed; and ECT, that had been long since abandoned in the treatment of schizophrenia until recent renewed interest, has emerged especially concerning the add-on of ECT to clozapine. However, ECT remains highly stigmatized and underutilized. This article looks at the history of the practice of ECT in schizophrenia with a historical and clinical approach and makes connections between the history of the treatment and its influence on its current recommendation and practice.
八十年前,精神分裂症是电休克治疗(ECT)的首个适应证,同样,ECT也是最早用于治疗精神分裂症的方法之一。本文介绍了ECT治疗精神分裂症的历史及其演变,从20世纪被发现开始,这是一系列“疗法”的经验主义范例。这一发现之后,在精神分裂症治疗缺乏疗效的背景下,ECT在精神分裂症中的应用在几十年间不断扩展。然后,第二次世界大战及ECT在德国的衍生应用之后,ECT的使用在几十年间有所下降。然而,在过去几十年里,ECT在精神分裂症治疗中的应用再度出现。的确,在精神分裂症患者中,治疗抵抗率一直很高,现在仍然如此。2017年,在氯氮平试验失败时定义了“难治性”的概念;而ECT,在精神分裂症治疗中早已被弃用,直到最近重新受到关注,尤其在ECT联合氯氮平治疗方面重新出现。然而,ECT仍然受到高度污名化且未得到充分利用。本文采用历史和临床方法审视ECT治疗精神分裂症的实践历史,并探讨该治疗方法的历史与其对当前推荐和实践的影响之间的联系。