Evaluation of the efficacy of the continuation electroconvulsive
					therapy in treatment-resistant schizophrenia

Gul, Isil Gogcegoz; Eryilmaz, Gul; Sayar, Gokben Hizli; Ozten, Eylem; Arat, Mustafa Murat; Tarhan, Nevzat

doi:10.1590/0101-60830000000018

Acessibilidade / Reportar erro

Brasil

Archives of Clinical Psychiatry (São Paulo)

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original articles • Rev. psiquiatr. clín. 41 (4) • Jul-Aug 2014 • https://doi.org/10.1590/0101-60830000000018 copy

Evaluation of the efficacy of the continuation electroconvulsive therapy in treatment-resistant schizophrenia

Avaliação da eficácia da eletroconvulsoterapia contínua para esquizofrenia resistente ao tratamento

Authorship SCIMAGO INSTITUTIONS RANKINGS

Background

: Electroconvulsive therapy (ECT) has been reported being a safe and effective treatment in schizophrenia. However, there are a limited number of studies assessing continuation ECT utilization in patients with schizophrenia giving partial response to pharmacological treatment.

Objective

: The aim of this study is to evaluate the effectiveness of continuation ECT in preventing relapse in patients with treatment-resistant schizophrenia.

Methods

: In this retrospective analysis, schizophrenia patients (n = 73) were defined in three groups such as patients who received only AP treatment (only AP), patients who received acute ECT only during hospitalization (aECT+AP), patients who received acute ECT and continuation ECT (a-cECT+AP). Three groups were compared according to positive and negative syndrome scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scores.

Results

: As per comparison of only AP group, aECT+AP group and a+cECT+AP groups in terms of after discharge PANSS and after discharge BPRS scores for 1^stmonth, 3^rd month and 6^th month; 3^rd and 6^th month’s PANSS scores of a+cECT+AP group were statistically significantly lower than other two groups.

Discussion

: Although this study suffers the limitations of retrospective medical chart analysis, results suggest that, in patients with a diagnosis of schizophrenia who have responded to an acute course of ECT, continuation ECT in combination with antipsychotics is more effective than antipsychotics alone in preventing relapse.

Continuation ECT; schizophrenia treatment-resistant; PANSS; BPRS

	Only AP group (n = 26)	aECT+AP group (n = 28)	a+cECT+AP group (n = 19)	p
Age (year) (Mean ± SD)	31.92 ± 7.82	31.82 ± 6.65	34.79 ± 9.80	0.39^a
Gender (n, %)
Female	10 (38.5%)	13 (46.4%)	7 (36.8%)	0.76^b
Male	16 (61.5%)	15 (53.6%)	12 (63.2%)
Marital status (n, %)
Married	11 (42.3%)	12 (42.9%)	11 (57.9%)	0.52^b
Single	15 (57.7%)	16 (57.1%)	8 (42.1%)
Education (n, %)
Primary school	19 (73.1%)	21 (75.0%)	13 (68.4%)	0.88^b
High school/+	7 (26.9%)	7 (25.0%)	6 (31.6%)
Occupation (n, %)
Working	4 (15.4%)	4 (42.6%)	3 (15.8%)	0.99^b
Not working	22 (84.6%)	24 (85.7%)	16 (82.2%)

	Only AP group (n = 26)	aECT+AP group (n = 28)	a+cECT+AP group (n = 19)	p

	(Mean ± SD)	(Mean ± SD)	(Mean ± SD)
Number of ECTs		9.71 ± 2.17	21.89 ± 9.80	0.0001 ^a
				0.0001 ^c
H-PANSS	107.12 ± 23.37	101.11 ± 22.90	110.00 ± 19.33	0.37^a
				0.58^b
				0.37^c
				0.90^d
D-PANSS	56.35 ± 9.47	51.11 ± 10.14	51.53 ± 12.36	0.15^a
				0.17^b
				0.99^c
				0.29^d
H-BPRS	45.35 ± 11.62	43.14 ± 15.85	60.32 ± 10.24	0.0001 ^a*
				0.81^b
				0.0001 ^c*
				0.001 ^d*
D-BPRS	19.27 ± 6.83	16.46 ± 6.63	31.37 ± 11.18	0.0001 ^a*
				0.42^b
				0.0001 ^c*
				0.0001 ^d*

	Only AP group (n = 26)	aECT+AP group (n = 28)	a+cECT+AP group (n = 19)	p
	(Mean ± SD)	(Mean ± SD)	(Mean ± SD)	p
1.month PANSS	54.81 ± 13.91	52.25 ± 10.83	51.16 ± 12.69	0.59^a
				0.73^b
				0.95^c
				0.60^d
3.month PANSS	68.35 ± 25.94	62.25 ±24.17	42.26 ± 12.12	0.001^a*
				0.58^b
				0.01^c*
				0.001^d*
6.month PANSS	73.50 ± 38.72	66.57 ± 37.46	33.37 ± 11.93	0.0001^a
				0.73^b
				0.004^c*
				0.0001^d*
1.month BPRS	18.88 ± 8.84	19.96 ± 13.64	29.84 ± 10.85	0.004^a*
				0.94^b
				0.01^c*
				0.006^d*
3.month BPRS	25.54 ± 13.90	25.54 ± 15.65	23.11 ± 9.94	0.80^a
				1.00^b
				0.82^c
				0.83^d
6.month BPRS	32.46 ± 23.32	28.29 ± 23.26	16.58 ± 8.57	0.04^a*
				0.74^b
				0.11^c
				0.03^d*

	Number of ECT	Number of ECT
	(n = 47) (r)	(n = 47) (p)
D-PANSS	(-0.320)	*(0.03)**
D-BPRS	(0.235)	(0.11)
1.month PANSS	(-0.219)	(0.14)
3.month PANSS	(-0.630)	*(0.0001)**
6.month PANSS	(-0.655)	*(0.0001)**
1.month BPRS	(0.231)	(0.12)
3.month BPRS	(-0.281)	(0.05)
6.month BPRS	(-0.464)	(0.001* )

Faculdade de Medicina da Universidade de São Paulo Rua Ovídio Pires de Campos, 785 , 05403-010 São Paulo SP Brasil, Tel./Fax: +55 11 2661-8011 - São Paulo - SP - Brazil
E-mail: archives@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Address correspondence to: Isil Gogcegoz Gul. Uskudar University, Department of Psychiatry, 34662 Istanbul, Turkey. Telephone: +90 5332076230; Fax: +90 216 4741256. E-mail: dr.isilggul@mynet.