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首页> 外文期刊>The journal of ECT >Short-Term Effect of ECT in Middle-Aged and Elderly Patients With Intractable Catatonic Schizophrenia.
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Short-Term Effect of ECT in Middle-Aged and Elderly Patients With Intractable Catatonic Schizophrenia.

机译：ECT对顽固性中枢性精神分裂症中老年患者的短期影响。

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BACKGROUND AND OBJECTIVEThe management of middle-aged and elderly patients with catatonic schizophrenia has long been a major problem in clinical geriatric psychiatry. Most cases are intractable because of medication resistance, medication intolerance, or severe medical conditions. Electroconvulsive therapy (ECT) is recognized as one of the most efficacious therapies for catatonic schizophrenia. Thus, we conducted a prospective study of the short-term effect of acute ECT on middle-aged and elderly patients with intractable catatonic schizophrenia.MATERIALS AND METHODSSubjects were nine consecutive patients older than 45 years who had fulfilled the DSM-IV criteria for catatonic-type schizophrenia and had been referred for first-time acute ECT after other treatments had failed. The patients were treated at Tohoku University Hospital between January 1998 and March 2002. We evaluated the clinical response of these patients to acute ECT by means of the brief psychiatric rating scale (BPRS). We also evaluated adverse effects of acute ECT.RESULTSThe response rate was 100%. The total BPRS score was improved in all nine subjects at the end of the ECT course and 1 week after the final session in comparison with the total pre-ECT BPRS score (11.9 +/- 7.5 and 9.3 +/- 9.2 versus 57.1 +/- 13.1, respectively, p = 0.008, p = 0.008). The total Global Assessment of Functioning score was also improved significantly (from 10.8 +/- 9.4 just before ECT to 61.6 +/- 18.9 1 week after ECT, p = 0.008). Guy's five factors (thought disturbance, activation, anxiety-depression, hostility-suspiciousness, and anergia) improved significantly (p = 0.008, p = 0.008, p = 0.018, p = 0.012, p = 0.008, respectively). One patient showed supraventricular premature contractions (SVPCs) during an ECT seizure. After some ECT sessions, three patients exhibited mild to moderate delirium that disappeared within 3 days. However, no patient experienced a severe cognitive or physical adverse effect during the course of ECT.CONCLUSIONSAcute ECT hasa good short-term effect on middle-aged and elderly patients with intractable catatonic schizophrenia and appears to be safe. Our results indicate that systematic studies on a large scale are warranted for further investigation of the efficacy and safety of acute ECT for treating middle-aged and elderly patients with catatonic schizophrenia.
机译：背景与目的中老年人精神分裂症的中老年患者的治疗一直是临床老年精神病学的主要问题。由于药物抵抗，药物耐受不良或严重的医疗状况，大多数情况难以治愈。电痉挛疗法（ECT）被认为是治疗强直性精神分裂症最有效的疗法之一。因此，我们对急性ECT对顽固性中度精神分裂症的中老年患者的短期疗效进行了前瞻性研究。材料与方法对象是连续9例年龄超过45岁且符合DSM-IV的中度精神分裂症标准的患者类型为精神分裂症，在其他治疗失败后被转诊为首次急性ECT。这些患者在1998年1月至2002年3月间在东北大学医院接受了治疗。我们通过简短的精神病学评定量表（BPRS）评估了这些患者对急性ECT的临床反应。我们还评估了急性ECT的不良反应。结果缓解率为100％。与ECT之前BPRS的总得分相比，ECT课程结束时和最后一届会议后1周，所有九名受试者的BPRS总得分均得到了改善（11.9 +/- 7.5和9.3 +/- 9.2与57.1 + / -分别为13.1，p = 0.008，p = 0.008）。总体功能评估总评分也得到了显着提高（从ECT前的10.8 +/- 9.4到ECT后1周的61.6 +/- 18.9，p = 0.008）。盖伊的五个因素（思维障碍，激活，焦虑抑郁，敌对性可疑和无痛）显着改善（分别为p = 0.008，p = 0.008，p = 0.018，p = 0.012，p = 0.008）。一名患者在ECT发作期间表现出室上性早搏（SVPC）。在一些ECT会议后，三名患者表现出轻度至中度del妄，并在3天内消失。然而，没有患者在ECT过程中出现严重的认知或身体不良反应。结论安全ECT对中老年顽固性精神分裂症的中老年患者具有良好的短期疗效，并且似乎是安全的。我们的结果表明，有必要进行大规模的系统研究，以进一步研究急性ECT治疗中晚期精神分裂症患者的疗效和安全性。

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