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Article: Electroconvulsive therapy improves antipsychotic and somnographic responses in adolescents with first-episode psychosis - A case-control study

TitleElectroconvulsive therapy improves antipsychotic and somnographic responses in adolescents with first-episode psychosis - A case-control study
Authors
KeywordsAdolescents
Electroconvulsive therapy (ECT)
First-episode psychosis
Polysomnography (PSG)
Issue Date2012
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/schres
Citation
Schizophrenia Research, 2012, v. 137 n. 1-3, p. 97-103 How to Cite?
AbstractObjective: Previous studies have demonstrated the effectiveness of electroconvulsive therapy (ECT) in pharmacotherapy-resistant neuropsychiatric conditions. This study aimed to evaluate the efficacy and safety of ECT in adolescents with first-episode psychosis. Method: This case-control study was conducted in inpatients aged 13-20. years with first-episode psychosis. Every three similar age and same gender patients consecutively recruited were randomly allocated to control and ECT group at a ratio of 1:2, while they had antipsychotic treatment. ECT treatment was performed for 3 sessions per week with a maximum of 14 sessions. The endpoint was discharge from hospital. Clinical outcomes were measured using hospital stay days, the Positive and Negative Syndrome Scale (PANSS) and response rate. Polysomnography (PSG) was conducted at baseline and at week 2. Safety and tolerability were also evaluated. Results: Between March 2004 and November 2009, 112 eligible patients were allocated to control (n. =. 38) and ECT (n. =. 74) group. Additional ECT treatment significantly reduced hospital stay compared to controls (23.2. ±. 8.2. days versus 27.3. ±. 9.3. days, mean. ±. SD, . P=. 0.018). Survival analysis revealed that the ECT-treated group had a significantly higher cumulative response rate than controls (74.3% versus 50%, relative risk (RR). =. 1.961, . P=. 0.001). Additional ECT also produced significantly greater improvement in sleep efficiency, rapid eye movement (REM) latency and density than control condition. The PSG improvement significantly correlated with reduction in scores on overall PANSS, positive symptoms, and general psychopathology. No patients discontinued ECT treatment regimen during hospital stay. The incidence of most adverse events was not different in the two groups, but ECT-treated group had more complaints of transient headache and dizziness than controls. Conclusions: ECT is an effective and safe intervention used in adolescents with first-episode psychosis. Its antipsychotic effects are associated with improved PSG variables. ECT can be considered as an early psychosis intervention. © 2012 Elsevier B.V.
Persistent Identifierhttp://hdl.handle.net/10722/161239
ISSN
2015 Impact Factor: 4.453
2015 SCImago Journal Rankings: 2.304
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorZhang, ZJen_HK
dc.contributor.authorChen, YCen_HK
dc.contributor.authorWang, HNen_HK
dc.contributor.authorWang, HHen_HK
dc.contributor.authorXue, YYen_HK
dc.contributor.authorFeng, SFen_HK
dc.contributor.authorTan, QRen_HK
dc.date.accessioned2012-08-16T07:38:45Z-
dc.date.available2012-08-16T07:38:45Z-
dc.date.issued2012en_HK
dc.identifier.citationSchizophrenia Research, 2012, v. 137 n. 1-3, p. 97-103en_HK
dc.identifier.issn0920-9964en_HK
dc.identifier.urihttp://hdl.handle.net/10722/161239-
dc.description.abstractObjective: Previous studies have demonstrated the effectiveness of electroconvulsive therapy (ECT) in pharmacotherapy-resistant neuropsychiatric conditions. This study aimed to evaluate the efficacy and safety of ECT in adolescents with first-episode psychosis. Method: This case-control study was conducted in inpatients aged 13-20. years with first-episode psychosis. Every three similar age and same gender patients consecutively recruited were randomly allocated to control and ECT group at a ratio of 1:2, while they had antipsychotic treatment. ECT treatment was performed for 3 sessions per week with a maximum of 14 sessions. The endpoint was discharge from hospital. Clinical outcomes were measured using hospital stay days, the Positive and Negative Syndrome Scale (PANSS) and response rate. Polysomnography (PSG) was conducted at baseline and at week 2. Safety and tolerability were also evaluated. Results: Between March 2004 and November 2009, 112 eligible patients were allocated to control (n. =. 38) and ECT (n. =. 74) group. Additional ECT treatment significantly reduced hospital stay compared to controls (23.2. ±. 8.2. days versus 27.3. ±. 9.3. days, mean. ±. SD, . P=. 0.018). Survival analysis revealed that the ECT-treated group had a significantly higher cumulative response rate than controls (74.3% versus 50%, relative risk (RR). =. 1.961, . P=. 0.001). Additional ECT also produced significantly greater improvement in sleep efficiency, rapid eye movement (REM) latency and density than control condition. The PSG improvement significantly correlated with reduction in scores on overall PANSS, positive symptoms, and general psychopathology. No patients discontinued ECT treatment regimen during hospital stay. The incidence of most adverse events was not different in the two groups, but ECT-treated group had more complaints of transient headache and dizziness than controls. Conclusions: ECT is an effective and safe intervention used in adolescents with first-episode psychosis. Its antipsychotic effects are associated with improved PSG variables. ECT can be considered as an early psychosis intervention. © 2012 Elsevier B.V.en_HK
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/schresen_HK
dc.relation.ispartofSchizophrenia Researchen_HK
dc.subjectAdolescentsen_HK
dc.subjectElectroconvulsive therapy (ECT)en_HK
dc.subjectFirst-episode psychosisen_HK
dc.subjectPolysomnography (PSG)en_HK
dc.subject.meshAntipsychotic Agents - therapeutic use-
dc.subject.meshElectroconvulsive Therapy - methods-
dc.subject.meshPsychotic Disorders - therapy-
dc.subject.meshSleep Disorders - etiology-
dc.subject.meshSleep Disorders - therapy-
dc.titleElectroconvulsive therapy improves antipsychotic and somnographic responses in adolescents with first-episode psychosis - A case-control studyen_HK
dc.typeArticleen_HK
dc.identifier.emailZhang, ZJ: zhangzj@hkucc.hku.hken_HK
dc.identifier.authorityZhang, ZJ=rp01297en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.schres.2012.01.037en_HK
dc.identifier.pmid22341901-
dc.identifier.scopuseid_2-s2.0-84862819916en_HK
dc.identifier.hkuros205000en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84862819916&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume137en_HK
dc.identifier.issue1-3en_HK
dc.identifier.spage97en_HK
dc.identifier.epage103en_HK
dc.identifier.isiWOS:000303933800015-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridZhang, ZJ=8061473900en_HK
dc.identifier.scopusauthoridChen, YC=43061002700en_HK
dc.identifier.scopusauthoridWang, HN=35109844400en_HK
dc.identifier.scopusauthoridWang, HH=10144885500en_HK
dc.identifier.scopusauthoridXue, YY=54797114400en_HK
dc.identifier.scopusauthoridFeng, SF=36570324100en_HK
dc.identifier.scopusauthoridTan, QR=7102120177en_HK
dc.identifier.citeulike10368891-

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