Efficacy of continuation ECT and antidepressant drugs compared to long-term antidepressants alone in depressed patients
Efficacy of continuation ECT and antidepressant drugs compared to long-term antidepressants alone in depressed patients
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DOI：
10.1176/appi.ajp.157.12.1960
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发表时间：
2000-12-01
影响因子：
17.7
通讯作者：
Price, LH
中科院分区：
文献类型：
--
作者：
Gagné, GG;Furman, MJ;Price, LH
目的：本研究的目的是评估持续ECT在depress.Method的疗效：作者采用回顾性图表审查，以确定29例患者谁收到持续ECT加长期抗抑郁治疗后，积极响应急性治疗与ECT抑郁发作（持续ECT组）。采用回顾性病例对照研究方法，确定匹配组29例患者，这些患者在对急性ECT反应阳性后单独接受长期抗抑郁药治疗（单独抗抑郁药组）。所有58例患者（46例单相抑郁症，12例双相情感障碍）在接受急性ECT治疗前均患有慢性抑郁症。使用生存分析和比例风险回归分析，以确定结果和危险factors.Results：所有患者的随访期的平均持续时间为3.9年（5.4年的连续ECT患者和2.4年的抗抑郁药单独的患者）的病历数据进行了分析。持续ECT组的结局明显更好。连续ECT治疗患者2年无复发或复发生存的累积概率为93%，单用抗抑郁药治疗患者为52%。在5年时，持续ECT患者的生存率下降至73%，但单独使用抗抑郁药的患者则下降至18%。平均生存时间为6.9年的连续ECT患者和2.7年的抗抑郁药单独patients.Conclusions：研究结果提供了强有力的支持，连续ECT加长期抗抑郁药治疗的疗效，在预防复发和复发的慢性抑郁症患者有反应的急性治疗与ECT。
Objective: The purpose of this study was to evaluate the efficacy of continuation ECT in depression.Method: The authors used retrospective chart review to identify 29 patients who received continuation ECT plus long-term antidepressant treatment after a positive response to acute treatment with ECT for a depressive episode (continuation ECT group). A retrospective case-controlled approach was used to ascertain a matching group of 29 patients who received long-term antidepressant treatment alone after responding positively to acute ECT (antidepressant-alone group). All 58 patients (46 with unipolar depression, 12 with bipolar disorder) had been chronically depressed before receiving acute ECT. Data from medical records were analyzed by using survival analysis and proportional hazards regression to determine outcome and risk factors.Results: The mean duration of the follow-up period for all patients was 3.9 years (5.4 years for the continuation ECT patients and 2.4 years for the antidepressant-alone patients). Outcome was significantly better in the continuation ECT group. The cumulative probability of surviving without relapse or recurrence at 2 years was 93% for continuation ECT patients and 52% for antidepressant-alone patients. At 5 years, survival declined to 73% for continuation ECT patients, but fell to 18% for antidepressant-alone patients. Mean survival times were 6.9 years for the continuation ECT patients and 2.7 years for the antidepressant-alone patients.Conclusions: The findings provide strong support for the efficacy of continuation ECT plus long-term antidepressant treatment in preventing relapse and recurrence in chronically depressed patients who have responded to acute treatment with ECT.