The effectiveness of electroconvulsive therapy: a literature review.

John Read, Richard Bentall
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引用次数: 120

Abstract

Aim: To review the literature on the efficacy of electroconvulsive therapy [ECT], with a particular focus on depression, its primary target group.

Methods: PsycINFO, Medline, previous reviews and meta-analyses were searched in an attempt to identify all studies comparing ECT with simulated-ECT [SECT].

Results: These placebo controlled studies show minimal support for effectiveness with either depression or 'schizophrenia' during the course of treatment (i.e., only for some patients, on some measures, sometimes perceived only by psychiatrists but not by other raters), and no evidence, for either diagnostic group, of any benefits beyond the treatment period. There are no placebo-controlled studies evaluating the hypothesis that ECT prevents suicide, and no robust evidence from other kinds of studies to support the hypothesis.

Conclusions: Given the strong evidence (summarised here) of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.

电休克治疗的有效性:文献综述。
目的:回顾电惊厥治疗[ECT]疗效的文献,特别关注其主要目标群体抑郁症。方法:检索PsycINFO、Medline、既往综述和荟萃分析,试图找出所有比较ECT与模拟ECT的研究[SECT]。结果:这些安慰剂对照研究显示,在治疗过程中,对抑郁症或“精神分裂症”的有效性支持最小(即,仅对某些患者,在某些措施上,有时只有精神科医生意识到,而其他评分者却没有察觉到),并且没有证据表明,对于任何一个诊断组,在治疗期后有任何益处。目前还没有安慰剂对照研究来评估ECT预防自杀的假设,也没有来自其他类型研究的有力证据来支持这一假设。结论:鉴于有强有力的证据(总结在这里)表明持续的,对一些人来说,永久性的脑功能障碍,主要表现为逆行性和顺行性健忘症,以及轻微但显著增加死亡风险的证据,ECT的成本-收益分析是如此之差,以至于不能科学地证明其使用的合理性。
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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