继续和维持电治疗的临床结果
Anders Jørgensen1,2, Frederikke Hoerdam Gronemann3, Maarten P Rozing1,4
1Psychiatric Center Copenhagen, Frederiksberg, Copenhagen, Denmark.
JAMA psychiatry
|September 18, 2024
概括
持续和维持电疗法 (c/mECT) 很少使用,但与单独的急性电疗法相比,它减少了再入院. 这些证据表明,应更频繁地考虑使用c/mECT,以防止治疗耐药症患者复发.
科学领域:
- 精神病学是一个精神病学.
- 神经学 神经学
- 卫生经济学 卫生经济学
背景情况:
- 缺乏继续和维持电治疗 (c/mECT) 有效性的大规模证据.
- 现实世界的结果和c/mECT的成本效益需要进一步调查.
研究的目的:
- 提供对c/mECT.的现实世界结果的详尽和自然的洞察力.
- 在大型数据集中评估c/mECT的成本效益.
主要方法:
- 通过使用丹麦国家患者登记册,对从2003年到2022年开始接受ECT的患者进行全国性队列研究.
- 一个算法识别了c/mECT,通过治疗频率和时间相对于急性ECT (aECT) 来定义.
- 考克斯比例危险回归,倾向得分匹配和自我控制的病例系列分析被用于评估结果;分析了成本效益.
主要成果:
- 在19,944名接受ECT治疗的人中,7.7%接受了c/mECT.
- c/mECT与aECT后住院率较低 (例如,6个月调整后的危险比率为0.68) 和总治疗成本大幅降低有关.
- 在自杀行为风险方面没有发现显著差异.
结论:
- 持续和维护电治疗 (c/mECT) 很少使用,但与单独的急性ECT (aECT) 相比,其再入院率降低.
- 这些发现表明,应该更频繁地考虑使用c/mECT,以防止治疗耐药症患者复发.
- c/mECT通过降低住院费用,显示出显著的成本效益.
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