برگشت بیماری پس از پاسخ به الکتروشوک در چهار اختلال روانپزشکی
Methods
Results
Discussion
References
Electroconvulsive therapy (ECT) is a neuromodulatory treatment for psychiatric disorders and its efficacy has been clinically well established. ECT induces generalized seizure activity in the brain by electrical stimulation and symptomatic improvement is mediated by yet-to-be-detailed biological mechanisms. While ECT is highly effective on specific symptoms, such as catatonia and acute psychotic episodes for mood disorders and schizophrenia, there is a high rate of relapse and preventing relapse is an important clinical objective. Pharmacotherapy and maintenance ECT have been used to prevent relapse – there are reports that lithium plus either nortriptyline or venlafaxine1,2 and maintenance ECT3–5 are effective against depression. Major psychiatric disorders, such as schizophrenia, depression, and bipolar disorder, have more in common than previously thought. Not only are the underlying genetics shared between disorders, mutations and modifications associated with particular genes also work in concert to manage brain signaling and genome function later in life.6–9 While various taxonomies exist to delineate psychiatric disorders, there is the concept in which schizophrenia, schizoaffective disorder, bipolar disorder, and depression are viewed as a continuum of psychiatric disorders.10 As ECT shows efficacy in patients with similar symptoms, such as catatonia, acute psychosis, and abnormal affect11 in both mood disorders and schizophrenia, it is possible that there could be shared factors associated with relapse. Therefore, in the current study, the four disorders were integrated as one and preventative factors associated with relapse for the four major psychiatric disorders were identified by retrospective analysis of patients’ medical records.