Can seizure therapies and noninvasive brain stimulations prevent suicidality? A systematic review.
Can seizure therapies and noninvasive brain stimulations prevent suicidality? A systematic review.
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DOI：
10.1002/brb3.2144
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发表时间：
2021-05
影响因子：
3.1
通讯作者：
Poulet E
中科院分区：
文献类型：
--
作者：
Chen Y;Magnin C;Brunelin J;Leaune E;Fang Y;Poulet E
自杀是一个重大的公共卫生问题，大多数试图自杀的人都患有精神障碍。除了精神药物治疗之外，癫痫治疗和无创脑刺激干预措施也已用于治疗此类患者。然而，这些非药物治疗对自杀意念和自杀发生率的影响仍不清楚。在这里，我们的目的是提供有关癫痫治疗和无创脑刺激对自杀的影响的最新信息。我们使用 MeSH 术语“电惊厥疗法”、“磁癫痫刺激”、“重复经颅磁刺激”、“经颅直流刺激”、“颅电刺激”和“自杀”，对 PubMed、EMBASE、Cochrane 对照试验中央注册库、Elsevier ScienceDirect 和 Wiley Online Library 数据库中的文献进行了系统回顾。我们纳入了使用癫痫治疗和无创脑刺激作为评估自杀倾向的主要干预措施的研究，无论诊断如何。在筛选的 1,019 份记录中，有 26 项研究符合纳入标准，使用电休克治疗 (n = 14)、磁癫痫治疗 (n = 2)、重复经颅磁刺激 (n = 9) 或经颅直流电刺激 (n = 1)。我们观察到，研究报告了显着的结果，表明这些技术可以有效地治疗心理健康病理学的自杀方面，但由于其局限性，对其功效的一般性陈述还为时过早。未来的研究有必要解决方法学的局限性，并评估这些方法单独使用以及与药物治疗和/或心理治疗相结合的长期疗效。我们提供了关于癫痫治疗（电惊厥治疗和磁癫痫治疗）和无创脑刺激（重复经颅磁刺激、经颅直流电刺激和经颅电刺激）对自杀影响的最新证据。 ECT 的抗自杀作用得到了支持，但磁癫痫治疗、重复经颅磁刺激、经颅直流电刺激和经颅电刺激并未一致推荐用于治疗自杀。应进一步研究癫痫治疗和无创脑刺激的长期抗自杀作用，无论是单独使用还是与药物治疗或心理治疗相结合。
Suicide is a major public health issue and the majority of those who attempt suicide suffer from mental disorders. Beyond psychopharmacotherapy, seizure therapies and noninvasive brain stimulation interventions have been used to treat such patients. However, the effect of these nonpharmacological treatments on the suicidal ideation and incidence of suicidality remains unclear. Here, we aimed to provide an update on the effects of seizure therapies and noninvasive brain stimulation on suicidality. We conducted a systematic review of the literature in the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Elsevier ScienceDirect, and Wiley Online Library databases using the MeSH terms “Electroconvulsive Therapy”, “Magnetic Seizure Stimulation”, “repetitive Transcranial Magnetic Stimulation”, “transcranial Direct Current Stimulation”, “Cranial Electrostimulation” and “suicide”. We included studies using seizure therapies and noninvasive brain stimulation as a main intervention that evaluated suicidality, regardless of diagnosis. Among 1,019 records screened, 26 studies met the inclusion criteria using either electroconvulsive therapy (n = 14), magnetic seizure therapy (n = 2), repetitive transcranial magnetic stimulation (n = 9), or transcranial direct current stimulation (n = 1). We observed that studies reported significant results, suggesting these techniques can be effective on the suicidal dimension of mental health pathologies, but a general statement regarding their efficacy is premature due to limitations. Future enquiry is necessary to address methodological limitations and evaluate the long‐term efficacy of these methods both alone and in combination with pharmacotherapy and/or psychotherapy. We provided an update of current evidence on the effects of seizure therapies (electroconvulsive therapy and magnetic seizure therapy) and noninvasive brain stimulations (repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and transcranial electrostimulation) on suicidality. The antisuicidal effect of ECT could be supported, but magnetic seizure therapy, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and transcranial electrostimulation were not consistently recommended for treating suicidality. Long‐term antisuicidal effect of seizure therapies and noninvasive brain stimulations should be further investigated both alone and in combination with pharmacotherapy or psychotherapy.
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