Influence of Age on Effectiveness and Tolerability of Electroconvulsive Therapy
Influence of Age on Effectiveness and Tolerability of Electroconvulsive Therapy
复制标题
DOI：
10.1097/yct.0b013e3181cadbf5
复制
发表时间：
2010-12-01
期刊：
影响因子：
2.5
通讯作者：
Baghai, Thomas C.
中科院分区：
文献类型：
--
作者：
Damm, Julia;Eser, Daniela;Baghai, Thomas C.
目的：电休克治疗（ECT）在所有年龄组的药物治疗抵抗性重性抑郁症和精神分裂症的有效性已被证明。然而，年龄特异性的不良反应，如更大的认知障碍和更高的躯体风险，由于医疗合并症和伴随用药可能是限制因素在老年patients.Methods：我们回顾性评估了4457治疗380例患者的ECT结果，安全性和不良反应的影响年龄。分析了临床变量、治疗方式和神经生理参数。为了模拟年龄对这些变量的影响，线性和logistic回归models.Results：我们的患者的平均（SD）年龄为51.2（15）岁，30%的年龄大于60岁。诊断为抑郁症占74.4%，精神分裂症占25.6%。我们发现，在所有年龄组中，临床症状均有显著改善。入院时疾病的严重程度越高，临床应答越好。分析60岁以上老年患者的治疗方式，未观察到合并精神药物的需求和数量存在显著差异，但在医疗合并药物方面存在显著差异。发作期和发作后的神经生理参数仅部分预测临床结果，但年龄对其中大部分有显着影响。短暂性心血管不良反应和认知障碍在老年人中更常见。在大多数情况下，有没有必要为任何特定的treatment.Conclusions：我们的数据证实了以前的研究表明ECT的良好效果，无论年龄。我们还发现，在我们的患者样本中，老年人的耐受性极佳。无死亡，仅发生一过性且无危及生命的不良事件。
Objectives: The effectiveness of electroconvulsive therapy (ECT) in pharmacotherapy-resistant major depressive disorder and schizophrenia has been shown for all age groups. Nevertheless, age-specific adverse effects such as greater cognitive impairment and higher somatic risks due to medical comorbidities and concomitant medication may be limiting factors in geriatric patients.Methods: We retrospectively evaluated 4457 treatments in 380 patients to investigate the influence of age on ECT outcome, safety, and adverse effects. Clinical variables, treatment modalities, and neurophysiological parameters were analyzed. For modeling the influence of age on these variables of interest, linear and logistic regression models were performed.Results: The mean (SD) age of our patients was 51.2 (15) years; 30% were older than 60 years. Diagnoses were major depressive disorder in 74.4% and schizophrenia in 25.6%. We found a considerable clinical improvement in all age groups. A higher severity of disease at admission corresponded to a better clinical response. Analyzing treatment modalities of elderly patients older than 60 years, no significant differences in need and number of concomitant psychotropic medications were seen, but significant differences were seen in medical co-medication. Ictal and postictal neurophysiological parameters were only in part predictive for clinical outcome, but age had a significant influence on most of them. Transient cardiovascular adverse effects and cognitive disturbances were more frequent in the elderly. In most cases, there was no need for any specific treatment.Conclusions: Our data confirm previous studies indicating the good effectiveness of ECT irrespective of age. We also found an excellent tolerability profile in the elderly in our patient sample. There was no mortality, and only transient and no life-threatening adverse events occurred.