Long-term quality of life in treatment-resistant depression after electroconvulsive therapy.
Long-term quality of life in treatment-resistant depression after electroconvulsive therapy.
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DOI：
10.1016/j.jad.2021.05.012
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发表时间：
2021-08-01
影响因子：
6.6
通讯作者：
Mickey BJ
中科院分区：
文献类型：
--
作者：
Lex H;Nevers SW;Jensen EL;Ginsburg Y;Maixner DF;Mickey BJ
电休克治疗（ECT）对难治性抑郁症（TRD）非常有效，先前的研究表明ECT后生活质量（QoL）短期改善。然而，ECT后的长期生活质量尚未研究，预测长期生活质量的基线患者特征仍然未知。本前瞻性纵向观察性研究入组了79例单极或双极TRD受试者。在基线和ECT后2年内每6个月使用简化的世界卫生组织生活质量量表（WHOQOL-BREF）测量身体、心理、社会和环境QoL领域。对基线社会人口统计学和临床特征与长期生活质量的相关性进行了检验。49名参与者提供了长期随访数据。相对于基线，随访期间平均心理和身体生活质量改善（Hedges效应量：0.27-0.83）。大约40-50%的人经历了临床上有意义的改善。在随后的两年中，ECT治疗的初始抗抑郁反应较好的受试者报告了较好的生活质量。长期生活质量改善最多的人是已婚，那些没有残疾的状态，和那些精神病特征或较短的抑郁发作在基线。参与者来自一个单一的美国学术中心，主要是欧洲血统，因此研究结果可能无法推广到其他环境或种族。观察性设计不允许因果推论。ECT治疗后的长期心理和身体生活质量结果差异很大。结果最好的人是那些最初对ECT反应良好的人，已婚人士，以及那些慢性病程较少的人。
Electroconvulsive therapy (ECT) is highly effective for treatment-resistant depression (TRD), and previous studies have demonstrated short-term improvements in quality of life (QoL) after ECT. However, long-term QoL after ECT has not been studied, and the baseline patient characteristics that predict long-term QoL remain unknown. Seventy-nine subjects with unipolar or bipolar TRD were enrolled in this prospective longitudinal observational study. Physical, psychological, social, and environmental QoL domains were measured with the abbreviated World Health Organization Quality of Life scale (WHOQOL-BREF) at baseline and every 6 months for up to 2 years after ECT. Baseline sociodemographic and clinical features were tested for association with long-term QoL. Long-term follow-up data were available from 49 participants. Relative to baseline, average psychological and physical QoL improved during the follow-up period (Hedges’ effect size: 0.27–0.83). About 40–50% of individuals experienced clinically meaningful improvement. Subjects with better initial antidepressant response with ECT reported better QoL over the subsequent two years. Long-term QoL improved most among individuals who were married, those without disability status, and those with psychotic features or shorter depressive episodes at baseline. Participants were from a single US academic center and mainly of European ancestry, so findings may not generalize to other settings or ethnicities. The observational design does not allow causal inferences. Long-term psychological and physical QoL outcomes vary widely after ECT. Individuals with the best outcomes are those who respond well to ECT initially, married people, and those with a less chronic course of illness.
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