在精神病单极性抑郁症的维持阶段使用电疗法
Ahmed Al-Wandi1, Mikael Landén2,3, Axel Nordenskjöld1
1University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Acta psychiatrica Scandinavica
|May 28, 2024
概括
维持性电治疗 (M-ECT) 没有显著改变精神病抑郁症的再入院或自杀率. 然而,对于65岁以上的患者,M-ECT显示这些不良结果的风险降低.
科学领域:
- 精神病学是一个精神病学.
- 临床神经科学 临床神经科学
- 老年医学 老年医学
背景情况:
- 精神病单极性抑郁症在治疗和长期管理方面带来了重大挑战.
- 电疗法 (ECT) 是一种有效的急性治疗方法,但维护ECT (M-ECT) 的作用需要进一步研究.
- 了解影响再入院和自杀风险的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 调查维持电疗法 (M-ECT) 与精神病重收和精神病单极抑郁症患者自杀率之间的关联.
- 要确定这种关联是否取决于患者的年龄.
- 为了比较接受M-ECT的患者和在初始ECT后没有接受M-ECT的患者的结果.
主要方法:
- 利用瑞典国家登记 (2008-2019) 识别精神病单极性抑郁症患者治疗ECT.
- 在出院后14天内接受M-ECT的患者和没有接受M-ECT的患者之间的结果进行了比较.
- 采用考克斯回归和个体内分析来评估在两年内的主要复合结果 (再录取,自杀企图或自杀).
主要成果:
- 总共有1873名患者被分析;130人接受了M-ECT.
- 在总样本中没有观察到主要结果的显著差异.
- 在65岁以上的患者中,M-ECT与复合结局风险降低显著相关 (aHR为0.55).
- 在个人内部的分析也有利于M-ECT.
结论:
- 在一般精神病抑郁症队列中,M-ECT与重新入院或自杀的不同风险无关.
- 在老年人 (65岁以上) 中,M-ECT与重新入院和自杀风险降低有显著关联.
- 不能排除在观察到的关联中存在残留混因素的可能性.
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