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[智力残疾者的电休克治疗]

[Electroconvulsive therapy in people with intellectual disability].

作者信息

Guhra M, Kreisel S H, Zilles-Wegner D, Sartorius A, Sappok T, Freundlieb N

机构信息

Medizinische Fakultät und Universitätsklinikum OWL, Evangelisches Klinikum Bethel, Universitätsklinik für Psychiatrie und Psychotherapie, Abt. für Gerontopsychiatrie, Universität Bielefeld, Bielefeld, Deutschland.

Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Göttingen, Deutschland.

出版信息

Nervenarzt. 2025 Mar;96(2):166-175. doi: 10.1007/s00115-024-01713-6. Epub 2024 Aug 21.

DOI:10.1007/s00115-024-01713-6
PMID:39240313
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11876283/
Abstract

Electroconvulsive therapy (ECT) is a highly effective treatment option for severe mental illness. Although people with intellectual disability (ID) have similar prevalence rates of mental disorders in comparison to the general population their access to ECT remains challenging. A systematic literature review was carried out on treatment with ECT in patients with ID and a case report on a patient with ID who underwent ECT is presented, to highlight a typical clinical routine. A total of 100 articles with 208 different case reports were retrieved. In summary, the results underline the effectiveness of ECT in people with ID, with side effects comparable to those in the general population. The ECT is effective in the treatment of severe affective and psychotic disorders and particularly in people with catatonia. The use of ECT can improve the patient's mental health and quality of life and is often a life-saving treatment option. The prophylaxis of relapses should be included as early as possible in the planning process. Providing an easy access to ECT treatment for people with ID is corroborated by its effectiveness and is in line with the right to equal treatment in accordance with article 25 of the United Nations Convention on the Rights of Persons with Disabilities.

摘要

电休克治疗(ECT)是治疗严重精神疾病的一种高效方法。尽管与普通人群相比,智力残疾(ID)患者的精神障碍患病率相似,但他们接受ECT治疗仍面临挑战。本文对ID患者接受ECT治疗进行了系统的文献综述,并呈现了一例接受ECT治疗的ID患者的病例报告,以突出典型的临床常规。共检索到100篇文章,包含208个不同的病例报告。总的来说,结果强调了ECT对ID患者的有效性,其副作用与普通人群相当。ECT对治疗严重情感和精神障碍有效,尤其对紧张症患者。ECT的使用可以改善患者的心理健康和生活质量,并且常常是一种挽救生命的治疗选择。复发预防应尽早纳入治疗计划过程。ECT治疗对ID患者的有效性证实了应为其提供便捷的ECT治疗途径,这也符合《联合国残疾人权利公约》第25条规定的平等治疗权。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef92/11876283/a4c0f60205dd/115_2024_1713_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef92/11876283/a4c0f60205dd/115_2024_1713_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef92/11876283/a4c0f60205dd/115_2024_1713_Fig1_HTML.jpg

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本文引用的文献

1
Unintended Weight Gain After Treatment of Catatonia With ECT in Autism: Case Report and Literature Review.自闭症患者电抽搐治疗后出现意外体重增加:病例报告及文献复习。
J ECT. 2023 Dec 1;39(4):269-270. doi: 10.1097/YCT.0000000000000935. Epub 2023 May 18.
2
Ethics Considerations in Laws Restricting Incapacitated Patients' Access to ECT.限制无行为能力患者接受电休克治疗的法律中的伦理考量
J Am Acad Psychiatry Law. 2023 Mar;51(1):47-55. doi: 10.29158/JAAPL.220029-21. Epub 2023 Jan 16.
3
Maintenance Electroconvulsive Therapy, Developmental Regression, Depression and Catatonia in an Adolescent With Down Syndrome: A Case Report.
唐氏综合征青少年的维持性电休克治疗、发育倒退、抑郁和紧张症:一例报告
Cureus. 2022 Nov 26;14(11):e31905. doi: 10.7759/cureus.31905. eCollection 2022 Nov.
4
Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis.使用 ECT 治疗自闭症谱系障碍和/或智力残疾:单站点回顾性分析。
J Autism Dev Disord. 2024 Mar;54(3):963-982. doi: 10.1007/s10803-022-05868-6. Epub 2022 Dec 17.
5
Unexplained regression in Down syndrome: Management of 51 patients in an international patient database.不明原因的唐氏综合征退行:国际患者数据库中 51 例患者的管理。
Am J Med Genet A. 2022 Oct;188(10):3049-3062. doi: 10.1002/ajmg.a.62922. Epub 2022 Aug 4.
6
Tardive Seizure in Patients With Intellectual Disabilities.智力残疾患者的迟发性癫痫发作
J ECT. 2023 Mar 1;39(1):56-57. doi: 10.1097/YCT.0000000000000872. Epub 2022 Jul 21.
7
Mental, Neurological, and Somatic Comorbidities and Their Treatment in Persons With Intellectual Disability.智力残疾患者的精神、神经和躯体共病及其治疗。
Dtsch Arztebl Int. 2022 Jun 17;119(24):418-414. doi: 10.3238/arztebl.m2022.0193.
8
Multiyear Evaluation of Maintenance Electroconvulsive Therapy in an Adult With Autism Spectrum Disorder, Catatonia, and Challenging Behavior.自闭症谱系障碍、紧张症和行为障碍成人患者维持电抽搐治疗的多年评估
J ECT. 2023 Mar 1;39(1):53-55. doi: 10.1097/YCT.0000000000000856. Epub 2022 Apr 23.
9
Electroconvulsive Therapy.电休克治疗
N Engl J Med. 2022 Feb 17;386(7):667-672. doi: 10.1056/NEJMra2034954.
10
Catatonia in autism spectrum disorders: A systematic review and meta-analysis.自闭症谱系障碍中的紧张症:系统评价和荟萃分析。
Eur Psychiatry. 2021 Dec 15;65(1):e4. doi: 10.1192/j.eurpsy.2021.2259.