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일 대학병원에서 시행한 전기경련요법의 치료적 효과

Clinical Effectiveness of Electroconvulsive Therapy in a University Hospital Setting

김희철|김양태|정성원|최영민
대한신경정신의학회 (Korean Neuropsychiatric Association)|2015.08|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제54권 제3호|pp. 330-337|DOI http://dx.doi.org/10.4306/jknpa.2015.54.3.330

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참고문헌

주제분류정신과학

초록

Objectives ZElectroconvulsive therapy (ECT) has become useful in psychiatric practice. This study was conducted to describe the clinical practice of ECT, including indications, efficacy, and side effects, in patients treated with modified unilateral or bilateral ECT. MethodsZZThe clinical records of patients treated with ECT during the period of January 2002 to December 2013 were evaluated retrospectively. A total of 107 patients (83 unilateral and 24 bilateral) were included in the analysis. Diagnostic categories treated were schizophrenia (46.7%), major depression (42.1%), bipolar disorder (9.3%), and obsessive-compulsive disorder (1.9%). Right unilateral or bilateral ECT was administered with brief pulse stimulation using modified ECT. Severity of illness and clinical improvement were measured using the Clinical Global Impressions (CGI) Scale. ResultsZZA positive response to ECT was found in 56.1% according to response criteria of the CGI-Improvement (CGI-I) score of 1 or 2. Response rates (based on CGI-I ≤2) for schizophrenia, major depression, bipolar disorder, and obsessive-compulsive disorder were 48.0%, 62.2%, 70.0%, and 50.0%, respectively (p=0.42). Although unilateral and bilateral ECT did not differ in rates of response, bilateral ECT resulted in more rapid onset of improvement. Bilateral ECT showed association with more adverse side effects (unilateral 31.3% vs. bilateral 70.8%). ConclusionZZECT is a highly effective and safe therapeutic option in the treatment of psychiatric illness, particularly in major mood disorder and schizophrenia. The use of ECT in a university hospital psychiatric unit in South Korea reflects similar results to those described in the international literature.

Abstract

Objectives ZElectroconvulsive therapy (ECT) has become useful in psychiatric practice. This study was conducted to describe the clinical practice of ECT, including indications, efficacy, and side effects, in patients treated with modified unilateral or bilateral ECT. MethodsZZThe clinical records of patients treated with ECT during the period of January 2002 to December 2013 were evaluated retrospectively. A total of 107 patients (83 unilateral and 24 bilateral) were included in the analysis. Diagnostic categories treated were schizophrenia (46.7%), major depression (42.1%), bipolar disorder (9.3%), and obsessive-compulsive disorder (1.9%). Right unilateral or bilateral ECT was administered with brief pulse stimulation using modified ECT. Severity of illness and clinical improvement were measured using the Clinical Global Impressions (CGI) Scale. ResultsZZA positive response to ECT was found in 56.1% according to response criteria of the CGI-Improvement (CGI-I) score of 1 or 2. Response rates (based on CGI-I ≤2) for schizophrenia, major depression, bipolar disorder, and obsessive-compulsive disorder were 48.0%, 62.2%, 70.0%, and 50.0%, respectively (p=0.42). Although unilateral and bilateral ECT did not differ in rates of response, bilateral ECT resulted in more rapid onset of improvement. Bilateral ECT showed association with more adverse side effects (unilateral 31.3% vs. bilateral 70.8%). ConclusionZZECT is a highly effective and safe therapeutic option in the treatment of psychiatric illness, particularly in major mood disorder and schizophrenia. The use of ECT in a university hospital psychiatric unit in South Korea reflects similar results to those described in the international literature.

참고문헌 (40)

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