頁籤選單縮合
題 名 | 精神分裂症電痙攣治療效應之預測因子=Predictors of Response to Electroconvulsive Therapy in Schizophrenia |
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作 者 | 謝明憲; 李信謙; 劉絮愷; 胡海國; | 書刊名 | 臺灣精神醫學 |
卷 期 | 12:3 1998.09[民87.09] |
頁 次 | 頁46-55 |
分類號 | 415.865 |
關鍵詞 | 精神分裂症; 電痙攣治療; 效應預測因子; Schizophrenia; Electroconvulsive therapy; Response predictors; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:電痙攣治療除適用於情感性精神病外,對於精神分裂症患者,亦有相當的療 效。本研究嘗試就國內之樣本,分析探討精神分裂症患者對電痙攣治療效應之預測因子。 方法:本研究主要針對5年間於台大醫院精神部急性病房住院、並接受電痙攣治療之精神分 裂症或分裂情感障礙症個案:評估其基本病史資料、臨床症狀與治療後之臨床改善程度,並以 卡方檢定、independent t-test 及邏輯迴歸進行分析。結果:5年間共73名精神分裂症或分 裂情感障礙症個案曾接受電痙攣治療,其中53.4%獲良好反應,46.6%則無明顯改善;對電痙攣 治療具良好反應者,其開始有治療反應之電痙攣次數與痙攣次收與痙姅時間分別是4.8次與 153.2秒左右。初步分析發現,其臨床改善程度與性別、精神分裂症亞型、家族病史、發病病 程、先前對治療之反應無關;而與進行電療前之激動性、行為解組程度、攻擊傾向呈現正相 關。進一步以邏輯迴歸分析,發現男性、高自殺傾向、高攻擊傾向及高行為解組程度可預測 其電療效應較佳。結論:本研究結果提示:某些特定人口學特徵與症狀之精神分裂症個案對電 療會有良好反應;對電療到底是否有明顯改善,可在固定之電痙攣次數及痙攣時間予以預 測;而邏輯迴歸模式之加入,亦說明電痙攣治療之效應,與特定之症狀�捷b向有關,間接印證了症 狀軸向之效度。 |
英文摘要 | Objectives:To identify the predictors of clinical response of Chinese schizophrenic patients treated with electroconvulsive therapy in Taiwan. Methods:The study subjects included 73 patients who were admitted to the acute psychiatric ward of National Taiwan University Hospital from 1991 to 1995 and received ECT during hospitalization. All of the subjects met the DSM-III-R criteria of schizophrenia or schizoaffective disorder. Their basic data, demographic characteristics, psychotic symptoms and ECT parameters were reviewed. Statistical analysis was performed using chisquare test, independent t-test and logistic regression. Results: A good response to ECT was achieved in 53.4% of patients and a poor response in 46.6%. Those good responders were found to have their significant therapeutic effect when ECT was given about 4.8 times or the seizure duration was 153.2 seconds. Bivariate analysis revealed that excitement, homicidal tendency/aggression and disorganized behavior were significantly associated with good ECT response. Logistic regression analysis showed that male, suicidal tendency, homicidal tendency/aggression, and disorganized behavior were good response predictors. This logistic regression model contained 6 factors and had a positive predictive rate of 73.97%. Conclusion: This study identified some specific clinical and demographic characteristics that may have good predictive value of response to ECT. The results of this study suggest that the symptom dimension of excitement can predict good response in schizophrenia. (Full Text in Chinese) |
本系統中英文摘要資訊取自各篇刊載內容。