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

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 1st month, 3rd month and 6th month; 3rd and 6th 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.**背景**：已有研究表明，电抽搐治疗（Electroconvulsive Therapy, ECT）是治疗精神分裂症的安全有效手段。然而，针对经药物治疗部分应答的精神分裂症患者，评估其维持性电抽搐治疗应用情况的研究仍较为匮乏。 **研究目的**：本研究旨在评估维持性电抽搐治疗对难治性精神分裂症患者的复发预防效果。 **研究方法**：本项回顾性分析共纳入73例精神分裂症患者，将其分为三组：仅接受抗精神病药物（Antipsychotic, AP）治疗组（仅AP组）、住院期间仅接受急性期电抽搐治疗联合抗精神病药物组（aECT+AP组），以及接受急性期电抽搐治疗联合维持性电抽搐治疗组（a-cECT+AP组）。三组患者以阳性和阴性症状量表（Positive and Negative Syndrome Scale, PANSS）及简明精神病评定量表（Brief Psychiatric Rating Scale, BPRS）评分作为比较依据。 **研究结果**：对比三组患者出院后1个月、3个月及6个月的PANSS与BPRS评分发现，a-cECT+AP组患者在出院后3个月及6个月的PANSS评分均显著低于另外两组，差异具有统计学意义。 **讨论**：尽管本研究存在回顾性病历分析固有的局限性，但研究结果提示，对于经急性期电抽搐治疗产生应答的精神分裂症患者，联合使用维持性电抽搐治疗与抗精神病药物，在预防复发方面的效果优于单纯抗精神病药物治疗。