对重复性抑郁障碍的成功电治疗后的复发预防策略的系统审查
Jordy J E Rovers1,2,3, Nander T van Zeijl1, Indira Tendolkar1,2
1Department of Psychiatry, Radboud University Medical Centerhttps://ror.org/05wg1m734, Nijmegen, The Netherlands.
BJPsych open
|January 14, 2026
概括
药疗和继续用药物进行电疗法 (ECT) 有效地预防ECT后重复出现严重抑郁症 (MDD). 对于其他策略,需要进一步研究.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床医学 临床医学
背景情况:
- 电疗法 (ECT) 是一种高度有效的治疗主要抑郁症 (MDD) 的方法.
- 大约50%的ECT治疗患者在一年内复发.
- 缺乏对经过ECT后复发预防策略的全面审查.
研究的目的:
- 系统地审查和评估用于预防MDD患者在ECT后复发的策略的证据.
- 评估药理学,神经调节,心理和组合方法.
- 识别当前研究中长期预防复发的缺陷.
主要方法:
- 按照PRISMA指南进行系统审查.
- 搜索的主要数据库 (PubMed,Embase,PsycInfo,Cochrane图书馆) 截至2025年3月.
- 包括RCT,队列研究,以及成年MDD患者对ECT反应的病例系列.
主要成果:
- ,单独或与抗抑郁药一起,显示出一致的复发减少.
- 连续ECT (C-ECT) 与药物治疗相结合也证明了复发的减少.
- 心理治疗的证据有限;没有发现重复性跨脑磁刺激或胺的研究.
结论:
- 药疗和C-ECT与药物是最有证据的复发预防策略.
- 目前的证据基础受到研究异质性,小样本大小以及对新或心理干预的少数研究的限制.
- 需要更强大的临床研究来建立最佳的长期复发预防策略.
相关概念视频
Electroconvulsive Therapy
864
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
864
Psychosis: Goals of Pharmacotherapy
466
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
466
Treatment Strategies for Psychological Disorders
721
Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
721
Psychological and Sociocultural Causes of Schizophrenia
466
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
466
Antidepressant Drugs: MAOIs and Other Agents
806
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
806


