국내 일 대학병원에서 시행된 전기경련요법의현황과 효과 및 안전성
Effectiveness and Safety of Electroconvulsive Therapy in Clinical Practice
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ObjectivesZZThere is little research on the practice and effectiveness of electroconvulsive therapy (ECT) in Korea. This study investigated the practice pattern, effectiveness, and safety of ECT. MethodsZZThis chart review study included electronic medical records of 180 patients treated with ECT between January 2007 and December 2013 at the Asan Medical Center. Symptomatic improvement was assessed using Clinical Global Impression (CGI) scale. Treatment response was defined as CGI improvement scale score of 2 or less. Re-hospitalization was used as an indicator of recurrence. Safety was assessed by spontaneous reports from patients. ResultsZZOne hundred and eighty patients underwent 1539 sessions of modified ECT. Their most frequent diagnosis was major depressive disorder (n=74, 41.1%). The most common indication for ECT was poor response to medication (n=177, 75.3%). Treatment response rate was 66.9% in acute phase group and 63.8% in the patients with poor response to medication. The recurrence rate at six months after the end of the course was 29.6%. Memory impairment or amnesia was the most common adverse effect. ConclusionZZThere was a remarkable improvement following ECT in patients who responded poorly to medications, and most adverse effects were tolerable and temporary. The present study suggests that ECT could be a useful treatment option.
Abstract
ObjectivesZZThere is little research on the practice and effectiveness of electroconvulsive therapy (ECT) in Korea. This study investigated the practice pattern, effectiveness, and safety of ECT. MethodsZZThis chart review study included electronic medical records of 180 patients treated with ECT between January 2007 and December 2013 at the Asan Medical Center. Symptomatic improvement was assessed using Clinical Global Impression (CGI) scale. Treatment response was defined as CGI improvement scale score of 2 or less. Re-hospitalization was used as an indicator of recurrence. Safety was assessed by spontaneous reports from patients. ResultsZZOne hundred and eighty patients underwent 1539 sessions of modified ECT. Their most frequent diagnosis was major depressive disorder (n=74, 41.1%). The most common indication for ECT was poor response to medication (n=177, 75.3%). Treatment response rate was 66.9% in acute phase group and 63.8% in the patients with poor response to medication. The recurrence rate at six months after the end of the course was 29.6%. Memory impairment or amnesia was the most common adverse effect. ConclusionZZThere was a remarkable improvement following ECT in patients who responded poorly to medications, and most adverse effects were tolerable and temporary. The present study suggests that ECT could be a useful treatment option.
참고문헌 (41)
- Accornero F, "An eyewitness account of the discovery of electroshock", Convuls Ther, 4, pp.40~49 (1988)
- Bini L, "Professor Bini’s notes on the first electro-shock experiment", Convuls Ther, 11, pp.260~261 (1995)
- Lambe S, "Trends in use of electroconvulsive therapy in South London from 1949 to 2006", J ECT, 30, pp.309~314 (2014)
- Fink M, "What was learned: studies by the consortium for research in ECT (CORE) 1997-2011", Acta Psychiatr Scand, 129, pp.417~426 (2014)
- Goldberg JF, "Antidepressant-induced mania: an overview of current controversies", Bipolar Disord, 5, pp.407~420 (2003)
- Price LH, "Adjunctive antidepressant treatment for bipolar depression", N Engl J Med, 357, pp.614~ (2007)
- Hasan A, "World Federation of Societies of Biological Psychiatry (WFSBP)Guidelines for Biological Treatment of Schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance", World J Biol Psychiatry, 13, pp.318~378 (2012)
- Kellner CH, "ECT in treatment-resistant depression", Am J Psychiatry, 169, pp.1238~1244 (2012)
- Pompili M, "Indications for electroconvulsive treatment in schizophrenia: a systematic review", Schizophr Res, 146, pp.1~9 (2013)
- Leiknes KA, "Contemporary use and practice of electroconvulsive therapy worldwide", Brain Behav, 2, pp.283~344 (2012)
- Vamos M, "The cognitive side effects of modern ECT: patient experience or objective measurement", J ECT, 24, pp.18~24 (2008)
- Prudic J, "Strategies to minimize cognitive side effects with ECT: aspects of ECT technique", J ECT, 24, pp.46~51 (2008)
- clinical psychiatry, "Kaplan & Sadock’s synopsis of psychiatry:behavioral sciences", pp.2014, Sadock BJ
- Eranti S, "A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression", Am J Psychiatry, 164, pp.73~81 (2007)
- Meron D, "Transcranial direct current stimulation (tDCS) in the treatment of depression: systematic review and meta-analysis of efficacy and tolerability", Neurosci Biobehav Rev, 57, pp.46~62 (2015)
- American Psychiatric Association, "The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging: a task force report of the American Psychiatric Association" (2001), American Psychiatric Press
- "Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Depression. Australian and New Zealand clinical practice guidelines for the treatment of depression", Australian and New Zealand J Psychiatry, 38, pp.389~407 (2004)
- Seo JS, "The Korean medication algorithm for depressive disorder: second revision", J Affect Disord, 167, pp.312~321 (2014)
- Vera I, "Electroconvulsive therapy practice in Spain: a national survey", J ECT, 32, pp.55~61 (2016)
- Sienaert P, "Improving practice in electroconvulsive therapy: a nationwide survey in Belgium", J ECT, 32, pp.29~32 (2016)
- Nordanskog P, "Electroconvulsive therapy in Sweden 2013: Data From the National Quality Register for ECT", J ECT, 31, pp.263~267 (2015)
- Martin BA, "Delivery of electroconvulsive therapy in Canada: a first national survey report on usage, treatment practice, and facilities", J ECT, 31, pp.119~124 (2015)
- 김기태, "국내 신경정신과 전문의의 전기경련요법에 대한 견해", 신경정신의학, 40(6), pp.1072~1089 (2001), 대한신경정신의학회
- 최영민, "일 대학병원에서 시행한 전기경련요법의 치료적 효과", 신경정신의학, 54(3), pp.330~337 (2015), 대한신경정신의학회[DOI]
- Park S, "Successful electroconvulsive therapy and improvement of negative symptoms in refractory schizophrenia with clozapine-induced seizures: a case report", Psychiatr Danub, 26, pp.360~362 (2014)
- Roh J, "Electroconvulsive therapy for major depressive disorder in a patient with a permanent skull defect: a case report", Asia Pac Psychiatry, 6, pp.454~457 (2014)
- Sackeim H, "Seizure threshold in electroconvulsive therapy. Effects of sex, age, electrode placement, and number of treatments", Arch Gen Psychiatry, 44, pp.355~360 (1987)
- Beale MD, "Stimulus dosing methods in electroconvulsive therapy", Psychiatr Ann, 28, pp.510~512 (1998)
- Frukacz A, "Fitting the treatment to the patient: recent advances in the practice of electroconvulsive therapy", Aust N Z J Psychiatry, 29, pp.484~491 (1995)
- Chanpattana W, "A survey of the practice of electroconvulsive therapy in Asia", J ECT, 26, pp.5~10 (2010)
- Connolly BS, "Pharmacological treatment of Parkinson disease:a review", JAMA, 311, pp.1670~1683 (2014)
- Ueda S, "Marked improvement of psychotic symptoms after electroconvulsive therapy in Parkinson disease", J ECT, 26, pp.111~115 (2010)
- Usui C, "Improvements in both psychosis and motor signs in Parkinson’s disease, and changes in regional cerebral blood flow after electroconvulsive therapy", Prog Neuropsychopharmacol Biol Psychiatry, 35, pp.1704~1708 (2011)
- Berg JE, "Electroconvulsive treatment of a patient with Parkinson’s disease and moderate depression", Ment Illn, 3, pp.e3~ (2011)
- Cumper SK, "Electroconvulsive therapy (ECT) in Parkinson’s disease: ECS and dopamine enhancement", J ECT, 30, pp.122~124 (2014)
- Muralidharan K, "Bifrontal ECT for drug-induced psychosis in Parkinson’s disease", Indian J Psychiatry, 53, pp.156~158 (2011)
- Petrides G, "Malhotra AK, et al. Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: a prospective, randomized study", Am J Psychiatry, 172, pp.52~58 (2015)
- Sackeim HA, "Continuation pharmacotherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial", JAMA, 285, pp.1299~1307 (2001)
- Kellner CH, "Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE)", Arch Gen Psychiatry, 63, pp.1337~1344 (2006)
- Husain MM, "Speed of response and remission in major depressive disorder with acute electroconvulsive therapy (ECT): a Consortium for Research in ECT (CORE) report", J Clin Psychiatry, 65, pp.485~491 (2004)
- Brodaty H, "“Side effects” of ECT are mainly depressive phenomena and are independent of age", J Affect Disord, 66, pp.237~245 (2001)
