The Effects of Focal Electrically Administered Seizure Therapy Compared With Ultrabrief Pulse Right Unilateral Electroconvulsive Therapy on Suicidal Ideation: A 2-Site Clinical Trial.
The Effects of Focal Electrically Administered Seizure Therapy Compared With Ultrabrief Pulse Right Unilateral Electroconvulsive Therapy on Suicidal Ideation: A 2-Site Clinical Trial.
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DOI：
10.1097/yct.0000000000000776
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发表时间：
2021-12-01
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影响因子：
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通讯作者：
Sackeim HA
中科院分区：
文献类型：
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作者：
Youssef NA;George MS;McCall WV;Sahlem GL;Short B;Kerns S;Manett AJ;Fox JB;Dancy M;Cook D;Devries W;Rosenquist PB;Sackeim HA
初步数据显示，与传统形式的ECT相比，局部电刺激癫痫疗法(FEAST)具有抗抑郁作用和较少的不良认知影响。本研究比较了FEAST和超短脉冲、右侧(UB-RUL)电刺激对自杀意念的影响。在两个地点，重度抑郁发作的患者根据他们的喜好接受FEAST或UB-RUL ECT的公开治疗。主要的结果衡量标准是自杀意念量表(SSI)上的分数。汉密尔顿抑郁量表(HRSD-SI)中自杀项目的得分提供了第二个结果衡量标准：39名患者纳入意向治疗样本(FEAST N=20；UB-RUL ECT N=19)。SSI和HRSD-SI的得分在两种干预措施下都得到了同等程度的降低。干预的应答者和非应答者都显示SSI和HRSD-SI得分显著降低，尽管治疗应答者的改善幅度更大。尽管受到开放标签、非随机设计的限制，与常规使用UB-RUL ECT相比，FEAST在自杀意念方面显示出类似的效果。这些结果令人鼓舞，并支持进一步研究和非自卑试验的必要性。
Preliminary data suggest that Focal Electrically-Administered Seizure Therapy (FEAST) has antidepressant effects and less adverse cognitive effects than traditional forms of ECT. This study compared the impact of FEAST and ultrabrief pulse, right unilateral (UB-RUL) ECT on suicidal ideation. At two sites, patients in a major depressive episode were treated openly with FEAST or UB-RUL ECT, depending on their preference. The primary outcome measure was scores on the Scale for Suicide Ideation (SSI). Scores on the suicide item of the Hamilton Rating Scale for Depression (HRSD-SI) provided a secondary outcome measure Thirty-nine patients were included in the intent-to-treat sample (FEAST N=20; UB-RUL ECT N=19). Scores on both the SSI and HRSD-SI were equivalently reduced with both interventions. Both responders and non-responders to the interventions showed substantial reductions in SSI and HRSD-SI scores, although the magnitude of improvement was greater among treatment responders. Although limited by the open label, non-randomized design, FEAST showed comparable effects on suicidal ideation when compared to routine use of UB-RUL ECT. These results are encouraging and support the need for further research and a non-inferiority trial.