一个基于德尔菲的全球专家共识,关于在重大抑郁障碍的电治疗成功后的复发预防策略
Jordy J E Rovers1,2, Philip F P van Eijndhoven1, Christopher Abbot3
1Department of Psychiatry, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands.
The American journal of psychiatry
|March 11, 2026
概括
电疗法 (ECT) 有效治疗抑郁症,但复发率很高. 专家共识建议药物治疗和持续ECT,根据临床因素个性化,以防止成功治疗后复发.
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
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.
- 经过ECT后的高复发率 (在一年内高达50%),需要强有力的复发预防策略.
- 目前的指导方针缺乏基于共识的,操作化的建议,用于预防ECT后复发.
研究的目的:
- 确定在ECT后常见的复发预防策略.
- 在国际ECT专家中评估这些策略的感知有效性.
- 为预防复发建立基于共识的个性化临床建议.
主要方法:
- 一项多轮的德尔菲研究,涉及18名国际ECT专家.
- 共识定义为对利克特级别答案达成80%以上的共识.
- 收集关于临床因素,药物治疗,继续ECT,心理治疗和新疗法的数据.
主要成果:
- 在影响复发的关键因素上达成共识:治疗耐药性,并发症,之前的ECT反应.
- 药物治疗 ( + 抗抑郁药) 已被批准用于所有患者.
- 继续 ECT (渐进) 建议高风险患者;心理治疗作为辅助.
- 没有关于重复性跨脑磁性刺激,胺,或最优持续时间超过6个月的共识.
结论:
- 建立了基于专家的指导,用于在MDD中预防ECT后复发.
- 药物治疗和延续ECT是核心策略,需要根据风险因素进行个性化.
- 需要进一步的研究来完善指导方针并改善长期结果.
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