Predictors of the short-term responder rate of Electroconvulsive therapy in depressive disorders - a population based study 英文参考文献.docVIP
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Predictors of the short-term responder rate of Electroconvulsive therapy in depressive disorders - a population based study 英文参考文献
Nordenskj?ldetal.BMCPsychiatry2012,12:115
/1471-244X/12/115
RESEARCH ARTICLE
OpenAccess
Predictorsoftheshort-termresponderrate
ofElectroconvulsivetherapyindepressive
disorders-apopulationbasedstudy
AxelNordenskj?ld1,3*,LarsvonKnorring2,3andIngemarEngstr?m3
Abstract
Background:TheaimofthepresentstudyistoinvestigatetheresponderrateofElectroconvulsivetherapy,ECT,
inclinicalroutineworkandtodefineclinicalcharacteristicspredictiveofresponsetoECT.Themainhypothesisis
thattheresponderrateofECTmightbelowerinclinicalroutinethanincontrolledtrials.
Methods:Thisisapopulation-basedstudyofallpatients(N=990)treatedwithECTfordepressivedisorders,
between2008–2010ineighthospitalsinSweden.PatientswithClinicalGlobalImpression-Improvementscoresof
1or2(muchimproved)withinoneweekafterECTwereconsideredresponderstoECT.Thepredictivevaluesof
singleclinicalvariablesweretestedbymeansofchi-squaredtestsandtherelativeimportancewastestedina
logisticregressionanalysis.
Results:Theresponderratewas80.1%.Ahigherproportionofolderpatients(50years)responded(84.3%vs.
74.2%,p0.001).Psychoticallydepressedpatientsrespondedbetter(88.9%vs.81.5%forseverelydepressedand
72.8%formildlydepressed,p0.001).Therewerenosignificantdifferencesinresponderratesbetweenpatients
sufferingfrombipolar,firstorrecurrentmajordepressivesyndromes,oradepressiveepisodeofschizoaffective
disorder.Patientswithpersonalitydisorderhadalowerresponderrate(66.2%vs.81.4%,p0.001).Also,outpatients
hadalowerresponderrate(66.3%)comparedtoinpatients(83.4%,p0.001).Inthelogisticregressionanalysis,
inpatientstatus,psychoticsymptoms,absenceofschizoaffectivedisorderandolderagewereindependentfactors
associatedwithresponsetoECT.
Conclusions:ThisstudyfocusesexclusivelyontheshorttermresponderratewithECTinclinicalpractice.
Similarlytoresultsfromcontrolledtrialsahighresponderrateisreported.Olderpatients,moreseverelyillpatients,
psychoticallyillpatientsandpatientswithoutpersonalitydisordershadthehighestresponderrates.Inpatients
mayhavebetteroutcomewithECTthanout
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