Grunhaus L, Shipley J E, Eiser A, Pande A C, Tandon R, Remen A, Greden J F
Department of Psychiatry, University of Michigan Medical Center, Ann Arbor.
Biol Psychiatry. 1994 Aug 15;36(4):214-22. doi: 10.1016/0006-3223(94)90602-5.
Electroconvulsive therapy (ECT) is highly effective in the treatment of major depressive disorder (MDD). The 1-year relapse rates are reported to be high and in the 30%-60% range, however. To test whether polysomnography (PS) can identify patients with a propensity for relapse we studied 20 patients, responders to a course of ECT, with PS studies. All patients met baseline diagnostic criteria for MDD, were treated with ECT following standardized protocols, had PS studies performed after the course of ECT in a medication-free state, received maintenance antidepressants postECT, and were followed periodically with phone interviews. The recurrence of depressive symptoms was determined at 3 months and 6 months after discharge. Fifty-five percent of the patients were symptomatic when evaluated 6 months after the ECT. Sleep Onset rapid eye movement (REM) periods were identified in 55% of the patients. As a group, patients who had experienced a recurrence of depressive symptoms by 6 months after discharge, had significantly shorter REM latencies after the course of ECT. A shorter REM latency after ECT identified patients who at six months demonstrated significant depressive symptomatology. Shortened REM latency after ECT in patients with MDD appears to be a correlate of vulnerability for relapse.
电休克疗法（ECT）在重度抑郁症（MDD）的治疗中非常有效。然而，据报道其1年复发率很高，在30%至60%之间。为了测试多导睡眠图（PS）是否能够识别有复发倾向的患者，我们对20名接受过ECT治疗且有反应的患者进行了PS研究。所有患者均符合MDD的基线诊断标准，按照标准化方案接受ECT治疗，在ECT疗程结束后处于无药物状态下进行PS研究，ECT后接受维持性抗抑郁药治疗，并通过电话访谈定期随访。在出院后3个月和6个月确定抑郁症状的复发情况。ECT后6个月进行评估时，55%的患者有症状。55%的患者出现睡眠起始快速眼动（REM）期。作为一个群体，出院后6个月内出现抑郁症状复发的患者在ECT疗程后REM潜伏期明显较短。ECT后REM潜伏期较短可识别出6个月时出现明显抑郁症状的患者。MDD患者ECT后REM潜伏期缩短似乎与复发易感性相关。
