吸烟史和饮酒史可预测精神分裂症患者接受电休克疗法的效果：一项多中心临床试验。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2024-09-30 DOI:10.1016/j.jpsychires.2024.09.045

Hongcheng Xie , Rong Ma , Minglan Yu , Tingting Wang , Jianning Chen , Junfan Liang , Jiajun Ren , Qingyu Tan , Shuangshuang Feng , Ping Wang , Hongli Zhang , Wanhong Peng , Kezhi Liu , Bo Xiang

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引用次数: 0

摘要

背景：目前的研究发现，性别、年龄和家族史等因素可以预测电休克疗法（ECT）对精神分裂症患者的疗效。在临床实践中，我们发现吸烟和饮酒的精神分裂症患者似乎比不吸烟和不饮酒的患者对电休克疗法的反应更有效。本研究旨在探讨吸烟史或饮酒史是否可作为精神分裂症患者电痉挛疗法疗效的预测指标：共有481名接受电痉挛疗法和抗精神病药物治疗（电痉挛疗法+抗精神病药物治疗）的患者完成了为期两周（六次电痉挛疗法）的随访；106名仅接受抗精神病药物治疗（抗精神病药物治疗）的患者也完成了为期两周的随访。对这些患者的吸烟、饮酒和 AP 药物使用情况进行了记录。精神病症状的严重程度使用阳性和阴性综合量表（PANSS）进行评估：电痉挛疗法 + AP 药物治疗：与无吸烟史的精神分裂症患者（非吸烟者）相比，有吸烟史的精神分裂症患者（吸烟者）的阴性症状明显减少（36.96% vs 24.76%; F = 5.974, p = 0.015）。与无饮酒史者（不饮酒者）相比，有饮酒史者（饮酒者）的阳性症状下降幅度较大（48.90% vs 41.47%；F = 5.074，p = 0.025）。AP 药物治疗：吸烟者与非吸烟者、饮酒者与非饮酒者在症状减轻方面没有差异（P > 0.05）：结论：精神分裂症患者的吸烟史可独立预测电痉挛疗法后阴性症状的改善情况，而饮酒史则可独立预测电痉挛疗法后阳性症状的改善情况。这是一项具有临床意义的发现。

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History of tobacco smoking and alcohol use can predict the effectiveness of electroconvulsive therapy in individuals with schizophrenia: A multicenter clinical trial

Background

Current research has found that factors such as gender, age, and family history can predict the efficacy of electroconvulsive therapy (ECT) in individuals with schizophrenia. In our clinical practice, we anecdotally observed that tobacco smokers and alcohol drinkers with schizophrenia seemed to respond more effectively to ECT than non-smokers and non-drinkers. The current study aimed to examine whether history of tobacco smoking or alcohol consumption serve as indicators for predicting therapeutic efficacy of ECT in individuals with schizophrenia.

Methods

A total of 481 individuals receiving ECT combined with antipsychotic medication (ECT + AP medication) completed a two-week (six sessions of ECT) follow-up; 106 individuals receiving only antipsychotic medication (AP medication) also completed a two-week follow-up. Smoking, alcohol consumption, and AP medication usage was recorded for these individuals. Severity of psychotic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS).

Results

ECT + AP medication: Compared to schizophrenic individuals without a history of smoking (non-smokers), those with a history of smoking (smokers) showed a high decrease in negative symptoms (36.96% vs 24.76%; F = 5.974, p = 0.015). While, compared to individuals without a history of alcohol consumption (non-drinkers), those with a history of alcohol consumption (drinkers) showed a high decrease in positive symptoms (48.90% vs 41.47%; F = 5.074, p = 0.025). AP medication: No differences were found in symptom reduction between smokers and non-smokers or between drinkers and non-drinkers (p > 0.05).

Conclusions

Smoking history in schizophrenic individuals independently predicts better improvement in negative symptoms after ECT, while alcohol consumption history independently predicts better improvement in positive symptoms after ECT. This is a clinically significant finding.

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;