Lemstra A, Leentjens A F, van den Broek W W
Academisch Ziekenhuis Rotterdam-Dijkzigt, afd. Psychiatrie.
Ned Tijdschr Geneeskd. 1996 Feb 3;140(5):260-4.
To evaluate the use and efficacy of electroconvulsive therapy (ECT) in refractory major depression according to DSM-III-R criteria, and to look for factors predicting response in the acute phase and the occurrence of relapse or recurrence after recovery.
Retrospective.
University Hospital Rotterdam, The Netherlands.
Of all patients who received ECT between January 1988 and July 1993 data were collected by study of clinical records and of information by treating physicians after discharge. Every patient was visited once, or received an outpatient department appointment, to obtain informed consent, take a follow-up history and evaluate social functioning by scoring Global Assessment of Functioning and Sickness Impact Profile rating scales.
35 patients received ECT. In clinical practice, the guidelines of the Netherlands Psychiatric Association were not violated; most patients had received adequate pharmacological pretreatment before the decision to start ECT was made. Two patients died in hospital (not from ECT). In the acute phase 25 of the 33 patients still alive upon discharge showed good recovery. Seven of these suffered relapse within six months. The number of patients with a return of depressive symptoms rose to 12 by the end of the first year of follow-up. Sociodemographic variables and treatment characteristics did not appear to influence the result of treatment in the acute phase, nor the occurrence of relapse or recurrence. With less intensive pre- and post-ECT drug treatment the chances of relapse were increased.
ECT is an effective treatment in the acute phase of a depression. Results after a longer period of follow-up are less satisfactory.
根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准，评估电休克治疗（ECT）在难治性重度抑郁症中的应用及疗效，并寻找预测急性期反应以及康复后复发或再发情况的因素。
回顾性研究。
荷兰鹿特丹大学医院。
对1988年1月至1993年7月期间接受ECT治疗的所有患者，通过研究临床记录以及出院后治疗医师提供的信息来收集数据。每位患者均接受一次访视，或获得门诊预约，以获取知情同意、采集随访病史，并通过对功能总体评定量表和疾病影响概况评定量表评分来评估社会功能。
35例患者接受了ECT治疗。在临床实践中，未违反荷兰精神科协会的指南；大多数患者在决定开始ECT治疗前已接受了充分的药物预处理。两名患者在医院死亡（非死于ECT）。在急性期，33例出院时仍存活的患者中有25例恢复良好。其中7例在6个月内复发。到随访的第一年末，出现抑郁症状复发的患者人数增至12例。社会人口统计学变量和治疗特征似乎既不影响急性期的治疗结果，也不影响复发或再发的发生。ECT治疗前后药物治疗强度较低时，复发几率会增加。
ECT是抑郁症急性期的一种有效治疗方法。较长时间随访后的结果不太令人满意。
