超级电休克在难治性抑郁中应用的临床研究:一项回顾性研究OA

Objective To evaluate the efficacy and safety of super electroconvulsive therapy(ECT)for treatment-resistant depression(TRD).Methods This cohort study was conducted among 292 patients with TRD,who received super ECT from December,2024 to June,2025.Eighty-eight of the patients received one electrical stimulation in each super ECT procedure(E1 group),89 had 2 electrical stimulations(E2 group),and 39 had 3 electrical stimulations(E3 group).The correlation between depression,anxiety and sleep quality at baseline was analyzed.The patients were evaluated using 17-items Hamilton Depression Scale(HAMD-17)at 1,3,and 6 months after the first super ECT session,and the treatment remission rate and response rate were compared among the 3 groups.The number of sessions and incidences of adverse events within 6 months were compared,and the EEG seizure duration at the first super ECT session was analyzed.Results Seventy-four patients(84.09%)in group E1,76(76.40%)in group E2,and 32(82.05%)in group E3 achieved remission within 6 months after super ECT.The average number of treatment sessions was 2.13±1.44 in Group E1,2.23±2.01 in Group E2,and 2.41±2.15 in Group E3 within 6 months.The baseline HAMA,HAMD-17 and PSQI scores were significantly correlated(P<0.001).The first seizure duration in E1 group was significantly longer than that in E2 and E3 groups(P<0.001).The rehospitalization rates were significantly higher in E2 group than in E1 group at 3 months(P=0.012)and 6 months(P=0.026).The short-term adverse effects included fever,headache/dizziness,general pain and dry mouth.Conclusion Super ECT is safe and effective for treatment of TRD patients with a total seizure duration longer than 180 s.The number of electrical stimulations in each treatment session does not significantly affect the therapeutic efficacy of super ECT.