Clinical application of modified electroconvulsive therapy in psychiatric inpatients / 新乡医学院学报

ABSTRACT

Objective To investigate the clinical application of modified electroconvulsive therapy (MECT),and provide the references for more standardized and rational use of MECT.Methods A retrospective study was performed by stratified random sampling method.The clinical data of 1 330 psychiatric inpatients from January 2006 to December 2015 in Henan Psychiatric Hospital were analyzed retrospectively,and the clinical application of MECT was investigated,including the proportion of psychiatric inpatients receiving MECT,the situation of combined use of MECT and antipsychotic drugs,and the routine examination results before and after MECT.Results The proportion of receiving MECT in schizophrenic patients was the highest,it is 11.36％ (81/713),the second was depressive episode (5.61％,12/214),followed by dissociative conversion disorder (5.56％,2/36),bipolar disorder (5.34％,7/131),organic mental disorder (3.23 ％,1/31) and other mental disorders (2.93％,6/205).There were significant differences in the distribution of various mental disorders between the non electroshock group and the electroshock group (x2 =21.728,P ＜ 0.05).The proportion of the patients without electric shock and the patients with single drug,two drugs,triple therapy or quadruple therapy was 0.92％,17.43 ％,56.88％,21.10％ and 3.67％,respectively.The proportion of the patients with two or more antipsychotic drugs was 81.65％ in the electroshock group.The antipsychotics were olanzapine (28.44％),clozapine (27.52％),quetiapine (26.61％) and risperidone (24.77 ％) according to the drugs used frequently in the electroshock group.The results of routine blood test were compared among the time points of before treatment,the 1st,2nd,3 rd week of MECT and 1 week after MECT in the shock group,which showed that there was significant difference in white blood cell count (F =2.570,P ＜ 0.05);but there was no significant difference in the levels of platelet,hemoglobin and red blood cell (P ＞ 0.05);the level of white blood cell returned to normal within two weeks in 93.33％ patients with increased white blood count.The myocardial enzymes and liver function tests were not perfect during the treatment of MECT and after treatment.There was no long-term systematic evaluation of cognitive function and quality of life in patients with electroconvulsive shock.Conclusions The probability of using MECT in the patients with schizophrenia is more than that in the patients with depression.MECT is used in combination with two or more antipsychotic drugs.MECT may cause a short increase in white blood cells,but the white blood cell level in most patients can recover to normal levels after symptomatic treatment.The clinical data for treatment and prognosis in patients with MECT are inadequate,so it is necessary to improve the medical record.