四川精神卫生2025，Vol.38Issue(4)：302-307,6.DOI:10.11886/scjsws20241101001
精神障碍患者改良电休克治疗的初始癫痫发作阈值的相关因素分析
Analysis of factors correlating with the initial seizure threshold in modified electroconvulsive therapy for patients with mental disorders
摘要
Abstract
Background Modified electroconvulsive therapy(MECT)is a common front-line strategy widely used in psychiatric practice,and the optimal first stimulus dosage in MECT is usually estimated clinically based on the factors influencing the patient's initial seizure threshold(IST).However,previous studies on the influencing factors of IST have mostly suffered from limitations such as small sample sizes and single-dimensional research perspectives.Objective To explore the factors influencing IST in MECT for patients with mental disorders,so as to provide references for stimulus dosing strategies in MECT for the patients.Methods A retrospective study was used to include 1 446 inpatients fulfilling the diagnostic criteria for any specific mental disorder listed in the ICD-10 and receiving MECT at Shandong Daizhuang Hospital from January 1,2021 to August 1,2023.Their general and clinical data were collected,including IST,psychiatric diagnostic categories,gender,ethnicity,age,body weight,body mass index(BMI),course of disease,family history of psychiatric disorders,first episode status,use of antiepileptic drugs the day before treatment,use of benzodiazepines the day before treatment,and previous MECT treatment history.Pearson correlation analysis was utilized to test the correlation of IST with age,height,body weight,BMI,and course of disease,and stepwise multivariate linear regression analysis was performed to identify the factors affecting IST.Results IST yielded statistical difference among patients in terms of gender,first episode status,use of antiepileptic drugs the day before treatment,and use of benzodiazepines the day before treatment(t=2.256,-3.059,-2.136,-3.006,P<0.05 or 0.01).IST in patients of different ages and psychiatric diagnostic categories also demonstrated statistical difference(F=913.120,6.212,P<0.01).Within young population,IST varied significantly based on the psychiatric diagnostic categories(F=2.986,P<0.05).Correlation analysis indicated that IST was positively correlated with age,body weight,BMI and course of disease(r=0.886,0.055,0.184,0.456,P<0.05 or 0.01),and negatively correlated with height(r=-0.183,P<0.01).Stepwise multivariate linear regression analysis revealed that age,gender,and body weight were influencing factors of IST(β=0.888,-0.049,-0.035,P<0.01).Conclusions Age,gender and body weight may be factors influencing IST in MECT for patients with mental disorders.关键词
改良电休克治疗/精神障碍/初始癫痫发作阈值/影响因素Key words
Modified electroconvulsive therapy/Mental disorders/Initial seizure threshold/Influencing factor分类
医药卫生引用本文复制引用
李迎寅,杨鹏,王美洁,时亚杰,李燕飞,李坤,张校明..精神障碍患者改良电休克治疗的初始癫痫发作阈值的相关因素分析[J].四川精神卫生,2025,38(4):302-307,6.基金项目
2024年济宁市重点研发计划项目(项目名称:精神障碍患者行无抽搐电休克治疗(MECT)首次能量阈值选择的预测研究,项目编号:2024YXNS202)Funded by Key R&D Plan Projects of Jining City in 2024(number,2024YXNS202) （项目名称:精神障碍患者行无抽搐电休克治疗(MECT）
