Clinical utility of electroconvulsive therapy for the treatment of multidrug‐resistant psychosis emerging in older adults: a case report
Clinical utility of electroconvulsive therapy for the treatment of multidrug‐resistant psychosis emerging in older adults: a case report
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电休克疗法治疗老年人出现的多重耐药性精神病的临床效用：病例报告
DOI：
10.1111/psyg.12877
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发表时间：
2022
期刊：
影响因子：
2
通讯作者：
Ikeda Manabu
中科院分区：
文献类型：
--
作者：
Satake Yuto;Sato Shunsuke;Yoshiyama Kenji;Shimura Yoko;Iwase Masao;Hashimoto Mamoru;Ikeda Manabu
“晚发性妄想症”和“极晚发性精神分裂症样精神病（VLOSLP）”描述了原发性精神障碍，不归因于痴呆和情感障碍，出现在60岁或以上（1，2）。尽管根据《精神障碍诊断和统计手册》第五版，此类患者被归类为精神分裂症或妄想性障碍患者，但女性优势和缺乏阴性症状等特征支持将VLOSLP与平均发作的精神分裂症谱系障碍区分开来的有效性。抗精神病药物被认为是平均发作型精神分裂症谱系障碍和VLOSLP的一线治疗药物。然而，一些VLOSLP患者对抗精神病药物的反应不充分，尽管许多报告支持其有效性（3）。关于平均发作的精神分裂症，氯氮平和电休克治疗（ECT）经常用于多药耐药病例。然而，只有少数报告强调了ECT治疗晚期出现的原发性精神障碍的有效性和安全性，并且尚未揭示导致长期良好反应的因素（1，4，5）。在此，我们报告一例迟发性耐多药精神病患者，在接受ECT和低剂量利培酮联合治疗一年后病情缓解。此外，我们讨论了ECT的潜力，一个良好的长期预后的晚期妄想症和VLOSLP的基础上，我们的经验和以前的报告，这一主题。
‘Late paraphrenia ‘and’very-late-onset schizophrenia-like psychosis (VLOSLP)’describe primary psychotic disorders, not attributed to dementia and affective disorders, that emerge at age 60 or older (1, 2). Although such patients are classified as patients with schizophrenia or delusional disorders according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, characteristics such as female preponderance and lack of negative symptoms support the validity of differentiating VLOSLP from average-onset schizophrenia spectrum disorders. Antipsychotics are considered the first-line treatment for both average-onset schizophrenia spectrum disorders and VLOSLP. However, some patients with VLOSLP do not respond sufficiently to antipsychotics, although many reports support their effectiveness (3). Regarding average-onset schizophrenia, clozapine and electroconvulsive therapy (ECT) are often administered in multidrugresistant cases. However, only a few reports have highlighted the effectiveness and safety of ECT for the treatment of primary psychotic disorders that emerge later in life, and the factors that contributing to long-term good response has not been revealed (1, 4, 5). Herein, we report a case of a patient with late-onset multidrug-resistant psychosis who achieved remission for over a year after a course of ECT and combined low-dose risperidone. Additionally, we discuss the potential of ECT for a good long-term prognosis of late paraphrenia and VLOSLP based on our experience and previous reports on this topic.
影响因子：
4
作者：
G. Figiel;K. Botteron;C. Zorumski;M. Jarvis;M. Doraiswamy;R. Krishnan
通讯作者：
R. Krishnan
老年精神分裂症和分裂情感障碍的急性电惊厥治疗：病例系列
影响因子：
3.5
作者：
D. Kumagaya
通讯作者：
D. Kumagaya
老年精神分裂症（“晚期精神分裂症”）的环境和遗传因素及其对精神分裂症因果关系一般问题的影响。
DOI：
--
发表时间：
1961
期刊：
Journal of Mental Science
影响因子：
--
作者：
D. Kay;M. Roth
通讯作者：
M. Roth