Electroconvulsive therapy or clozapine for adolescents with treatment-resistant schizophrenia: an explorative analysis on symptom dimensions.

IF 2.9 4区医学 Q2 PSYCHIATRY

International Journal of Psychiatry in Clinical Practice Pub Date : 2023-09-01 DOI:10.1080/13651501.2022.2160764

Mustafa Tuncturk, Cagatay Ermis, Dicle Buyuktaskin, Serkan Turan, Yesim Saglam, Sezen Alarslan, Duru Guler, Ekin Sut, Guldal Unutmaz, Ayse Beste Guzel, Ozge Atay Canbek, Neslihan Inal, Gul Karacetin, Philip Hazell

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引用次数: 0

Abstract

Objective: This study sought to compare pre-intervention patient characteristics and post-intervention outcomes in a naturalistic sample of adolescent inpatients with treatment-resistant psychotic symptoms who received either electroconvulsive therapy (ECT) or clozapine.

Methods: Data of adolescents with schizophrenia/schizoaffective disorder receiving ECT or clozapine were retrospectively collected from two tertiary-care psychiatry-teaching university hospitals. Subscale scores of the Positive and Negative Symptom Scale (PANSS) factors were calculated according to the five-factor solution. Baseline demographics, illness characteristics, and post-intervention outcomes were compared.

Results: There was no significant difference between patients receiving ECT (n = 13) and clozapine (n = 66) in terms of age, sex, and the duration of hospital stay. The ECT group more commonly had higher overall illness and aggression severity. Smoking was less frequent in the clozapine group. Baseline resistance/excitement symptom severity was significantly higher in the ECT group, while positive, negative, affect, disorganisation, and total symptom scores were not. Both interventions provided a significant reduction in PANSS scores with large effect sizes.

Conclusion: Both ECT and clozapine yielded high effectiveness rates in adolescents with treatment-resistant schizophrenia/schizoaffective disorder. Youth receiving ECT were generally more activated than those who received clozapine.

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电惊厥治疗或氯氮平治疗难治性精神分裂症:症状维度的探索性分析

目的:本研究旨在比较具有治疗抵抗性精神病症状的青少年住院患者接受电休克治疗(ECT)或氯氮平治疗的干预前患者特征和干预后结果。方法:回顾性收集两所大学三级精神病学教学医院接受ECT或氯氮平治疗的青少年精神分裂症/分裂情感性障碍患者的资料。根据五因子解计算阳性和阴性症状量表(PANSS)因子的子量表得分。比较基线人口统计学、疾病特征和干预后结果。结果:接受ECT治疗的患者(13例)与接受氯氮平治疗的患者(66例)在年龄、性别、住院时间等方面无显著差异。ECT组通常有更高的整体疾病和攻击严重程度。氯氮平组吸烟较少。ECT组的基线抵抗/兴奋症状严重程度显著高于对照组，而阳性、阴性、情绪、紊乱和总症状评分则无显著差异。两种干预措施均显著降低了PANSS评分，且效果显著。结论:电痉挛疗法和氯氮平治疗难治性精神分裂症/分裂情感性障碍的青少年有效率高。接受ECT治疗的青少年通常比接受氯氮平治疗的青少年更活跃。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Psychiatry in Clinical Practice 医学-精神病学

CiteScore

6.00

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Psychiatry in Clinical Practice provides an international forum for communication among health professionals with clinical, academic and research interests in psychiatry. The journal gives particular emphasis to papers that integrate the findings of academic research into realities of clinical practice. Focus on the practical aspects of managing and treating patients. Essential reading for the busy psychiatrist, trainee and interested physician. Includes original research papers, comprehensive review articles and short communications. Key words: Psychiatry, Neuropsychopharmacology, Mental health, Neuropsychiatry, Clinical Neurophysiology, Psychophysiology, Psychotherapy, Addiction, Schizophrenia, Depression, Bipolar Disorders and Anxiety.