Contemporary use and practice of electroconvulsive therapy worldwide.
Contemporary use and practice of electroconvulsive therapy worldwide.
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DOI：
10.1002/brb3.37
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发表时间：
2012-05
影响因子：
3.1
通讯作者：
Hoie, Bjorg
中科院分区：
文献类型：
--
作者：
Leiknes, Kari Ann;Jarosh-von Schweder, Lindy;Hoie, Bjorg
探索当代（自 1990 年以来）世界范围内电休克治疗 (ECT) 的利用和实践。在 Medline、Embase、PsycINFO、SveMed 和 EBSCO/Cinahl 数据库中进行了系统检索（仅限于 1990 年及之后发表的研究）。基于主要数据的研究/调查，报告了国际、国家和地区精神病机构中 ECT 的使用和实践；城市被包括在内。两名评审员根据纳入标准独立检查研究标题和摘要，并从全文检索的数据中提取 ECT 使用和实践数据。共纳入 70 项研究，其中 7 项来自澳大利亚和新西兰，3 项来自非洲，12 项来自北美和拉丁美洲，33 项来自欧洲，15 项来自亚洲。全球 ECT 差异和趋势很明显，每位患者平均接受 ECT 次数为 8；亚洲（超过 90%）、非洲、拉丁美洲、俄罗斯、土耳其、西班牙使用未经改良（无麻醉）的药物。除了某些地方（欧洲和澳大利亚/新西兰）的单侧电极放置之外，世界范围内首选的电极放置方式是双边的。虽然主流是短脉冲波，但仍使用正弦波器件。在西方国家，接受 ECT 治疗的大多数是患有抑郁症的老年女性，而在亚洲国家，接受 ECT 治疗的是患有精神分裂症的年轻男性。一些网站注意到非自愿情况下的 ECT（入院）、流动 ECT 的使用、急性一线治疗以及由其他专业人员（老年科医生、护士）实施的情况。总的趋势是同一国家内只有一些机构提供 ECT，培训不足，并且没有遵循指导方针。强制报告和整个国家 ECT 登记数据很少。如今，许多患者仍在接受未经改良的 ECT 治疗。全球 ECT 使用、管理和实践存在巨大差异，因此需要在全球范围内共享有关 ECT 的知识、反思并学习彼此的经验。
To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data-based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief-pulse wave, sine-wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory-ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences.
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