针对精神病与非精神病性抑郁症的电疗法的临床有效性:一项队列研究
Radhika Kelkar1,2, George C Liu1, Michelle S Goodman2
1Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
The Journal of clinical psychiatry
|February 3, 2025
概括
电疗法 (ECT) 在患有精神病特征 (MD-P) 的严重抑郁症患者中显示出更高的反应率,但当考虑其他患者特征时,这种差异会消失. 不良的认知影响在各组之间是相似的.
科学领域:
- 精神病学是一个精神病学.
- 神经科学是一个神经科学.
- 临床心理学 临床心理学
背景情况:
- 具有精神病特征的严重抑郁症 (MD-P) 与没有精神病特征的严重抑郁症 (MD-NP) 相比,可能对电疗法 (ECT) 有不同的反应.
- 以前的假设表明,在接受ECT的MD-P患者中,结果更好,认知副作用更少.
- 超出精神病症状的患者特征可能会影响观察到的差异.
研究的目的:
- 为了比较MD-P和MD-NP患者之间的ECT治疗反应.
- 为了比较MD-P和MD-NP患者之间ECT的不良认知影响.
- 确定与这些患者群体中ECT治疗反应或不良认知影响相关的因素.
主要方法:
- 在2010年6月至2021年9月期间,成年住院患者接受ECT治疗的回顾性队列研究.
- 使用后勤回归分析来控制混患者特征.
- 用标准化临床和认知尺度评估治疗反应和认知效应.
主要成果:
- 在542名患者中,115人患有MD-P,427人患有MD-NP. MD-P患者的初始"大大改善"率较高 (41%对27%).
- 在MD-P和MD-NP组之间,不良认知影响是可比的 (24%对21%).
- 经过对混因素进行调整后,精神病症状与治疗反应或不良认知影响没有显著的关联.
结论:
- 虽然MD-P患者的初始反应率似乎更高,但ECT在MD-P和MD-NP组中显示出类似的认知副作用概况.
- 在考虑到其他患者变量后,MD-P患者观察到的更高的应答率没有持续.
- 当考虑其他因素时,单独的精神病症状似乎不是ECT治疗反应或认知副作用的预测因素.
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