Cohen D, Dubos P F, Basquin M
Service de Psychopathologie de l'Enfant et de l'Adolescent, Clinique Georges Heuyer, Hôpital de la Salpêtrière, Paris.
Encephale. 1997 Jul-Aug;23(4):308-11.
Despite the progress of pharmocotherapy, electroconvulsive therapy (ECT) is still used in a majority of countries to treat severe intractable mental disorders of the youth, yet few studies have been conducted to assess its use for individuals under 20-year-old. Efficacy, indications, side effects, technical characteristics and outcome are uncertain. A review of the 96 cases reported in the literature shows that: 1) its average frequency in adolescent psychiatric practice is similar throughout western nations and can be estimated around one ECT every year per million people; 2) intractable mood disorders, both manic and depressive episodes, are its main indications, since ECT treated more than 90% of the 66 cases reported; ECT can also offer an interesting alternative in some schizoaffective and schizophrenic episodes, in particular catatonic ones; 3) tolerance appears to be good, although secondary effects may occur. The most serious ones are infrequent spontaneous seizures and more common memory loss. Although no prospective studies are available on the evolution of cognitive side effects, they seem to disappear within a few weeks.
尽管药物治疗取得了进展，但在大多数国家，电休克疗法（ECT）仍被用于治疗青少年严重的难治性精神障碍，然而，针对20岁以下个体使用该疗法的评估研究却很少。其疗效、适应症、副作用、技术特性和治疗结果尚不确定。对文献报道的96例病例的综述表明：1）在西方国家，青少年精神病治疗中其平均使用频率相似，估计约为每年每百万人中有1次ECT治疗；2）难治性情绪障碍，包括躁狂和抑郁发作，是其主要适应症，因为ECT治疗了报道的66例病例中的90%以上；ECT在一些分裂情感性和精神分裂症发作中，特别是紧张性发作中，也可提供一种有效的替代方法；3）耐受性似乎良好，尽管可能会出现副作用。最严重的副作用是罕见的自发性癫痫发作和更常见的记忆丧失。虽然目前尚无关于认知副作用演变的前瞻性研究，但它们似乎在几周内就会消失。
