ABSTRACT
BACKGROUND: Traditional treatments for major depressive disorder (MDD), including medication and therapy, often fail and have undesirable side effects. Electroconvulsive therapy (ECT) uses electrical currents to induce brief seizures in the brain, resulting in rapid and potent antidepressant effects. However, owing to misconceptions and controversies, ECT is not as widely used as it could and often faces stigmatization. AIM: To evaluate the efficacy and safety of ECT compared to those of medication and/or therapy in patients with severe MDD. METHODS: This prospective cohort study included 220 individuals with severe MDD who were divided into the ECT and non-ECT groups. The patients in the ECT group underwent bilateral ECT three times a wk until they either achieved remission or reached a maximum of 12 sessions. The non-ECT group received medication and/or therapy according to clinical guidelines for MDD. The primary outcome was the variation in the hamilton depression rating scale (HDRS) score from treatment/ECT initiation to week 12. In addition, patients' quality of life, cognitive abilities, and biomarkers were measured throughout the study. RESULTS: Although both groups showed significant improvements in their HDRS scores over time, the improvement was more pronounced in the ECT group than in the non-ECT group. Additionally, the ECT group exhibited a more substantial improvement in the quality of life and cognitive function than those of the non-ECT group. Compared with the non-ECT group, the ECT group exhibited evi-dently lower variations in the brain-derived neurotrophic factor (BDNF) and cytokine interleukin-6 (IL-6) levels. The side effects were generally mild and comparable between the two groups. ECT is safer and more potent than medication and/or therapy in mitigating depressive symptoms, enhancing well-being, and bolstering cognitive capabilities in individuals with severe MDD. ECT may also affect the levels of BDNF and IL-6, which are indicators of neuroplasticity and inflammation, respectively. CONCLUSION: ECT has emerged as a potentially advantageous therapeutic approach for patients with MDD who are unresponsive to alternative treatments.
ABSTRACT
Shift work is associated with circadian rhythm disruption that manifests in several aspects related to sleep disorder, including trouble falling asleep, shortened sleep, and daytime fatigue. The objective of this study was to investigate the effects of shift work on sleep and cognitive function in the middle-aged male miners in Kailuan Mining Group. From May 2013 to May 2015, male miners were recruited and enrolled in prospective study. The results of PSQI demonstrated that there were significant differences in the total score, subjective sleep quality and sleep duration between two groups. For subjects with education level of senior middle school or below, our results showed that the scores of BVMT-R and HVLT-R in the day shift group were significantly higher than that in the night shift group. According to PSQI score, further test was conducted for HVLT-R and BVMT-R. For subjects with PSQI score≤5, there were significant differences in HVLT-R scores between two groups. In terms of PSQI score>5, BVMT-R scores in the night shift group were significantly lower than that in the day shift group. The workers for night shift work in adulthood would tend to impaired working memory. Education can also influence the performance of working memory.
