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Wirksamkeit einer EKT-Erhaltungstherapie (EEKT) bei Patienten mit therapieresistenten affektiven Störungen – Ergebnisse einer retrospektiven Datenanalyse

Efficacy of continuation and maintenance electroconvulsive therapy (c/m ECT) in the treatment of patients with therapy-resistant affective disorders: a retrospective analysis

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Zusammenfassung

Grundlagen

Die Erhaltungs-Elektro-Konvulsionstherapie (EEKT) ist eine Möglichkeit der Erhaltungstherapie bei Patienten mit schwer und chronisch verlaufenden affektiven Störungen. Für sie liegen aktuell nur wenige empirische Studien vor und dementsprechend gibt es einen hohen Bedarf an neuen Forschungsergebnissen.

Methoden

Wir berichten über die Ergebnisse einer retrospektiven Datenanalyse von Patienten, die in den letzten 10 Jahren eine EEKT erhielten. Die klinische Wirksamkeit wurde über einen intraindividuellen Vergleich von Anzahl und Dauer der stationären Aufenthalte vor und nach Beginn der EEKT gemessen.

Ergebnisse

19 Patienten (63 % weiblich; 53,5 ± 12,0 Jahre alt) mit entweder bipolarer (42 %) oder unipolarer (58 %) affektiver Störung, die bei stationärer Aufnahme größtenteils an einer depressiven Episode (95 %) litten, erhielten nach einer erfolgreichen Akutbehandlung mit EKT eine EEKT. In einem 5-Jahres-Vergleichszeitraum vor und nach Beginn mit EEKT konnten sowohl die Anzahl der stationären Aufenthalte pro Jahr (0,87 Aufenthalte vorher vs. 0,28 nachher, p < 0,001), ebenso wie die stationären Aufenthaltstage insgesamt (30,8 Tage vorher vs. 4,5 Tage nachher, p < 0,001) und deren durchschnittliche Dauer (30,5 Tage vorher vs. 16,7 Tage nachher, p = 0,02) signifikant reduziert werden.

Schlussfolgerung

Unsere Ergebnisse unterstützen die aktuelle Datenlage und bestätigen, dass eine Kombination von EEKT und Erhaltungspharmakotherapie den Verlauf von therapierefraktären affektiven Störungen verbessert. Für Evidenz-basierte Richtlinien hinsichtlich Indikationsstellung und Durchführung der EEKT benötigt es in Zukunft Studien mit kontrolliertem Design und größeren Fallzahlen.

Summary

Background

Continuation and maintenance electroconvulsive therapy (c/m ECT) is a long-term treatment option in severely and chronically ill patients with mood disorders, who are unresponsive or intolerant to medication. Due to the current lack of empirical studies, c/m ECT is still a clinical tool with little evidence.

Methods

We conducted a retrospective analysis of patients’ charts who received c/m ECT over a 10-year period. Outcome was measured by comparing the number of pre-c/m ECT and post-c/m ECT hospitalizations, as well as inpatient days per year and mean duration of hospital stays.

Results

In 19 patients (63 % female; mean age 53.5 ± 12.0 years) with either bipolar (42 %) or unipolar (58 %) mood disorder, with the majority of patients suffering from a depressive episode at hospital admission (95 %), c/m ECT was initiated after a successful series of ECT. In a 5-year interval before and after starting c/m ECT the number of hospitalizations per year (0.87 vs. 0.28, p < 0.001), inpatient days per year (30.8 vs. 4.5 days, p < 0.001), as well as the mean duration of hospital days (30.5 vs. 16.7 days, p = 0.02) decreased significantly.

Conclusion

Our data support previous results showing that c/m ECT is an efficacious option in treating and favourably altering the course of therapy-resistant affective disorders. Further research using a controlled study design and larger sample sizes are needed to convincingly define indication and performance of c/m ECT.

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Authors and Affiliations

  1. Department Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich

    Thomas Post MD,  Georg Kemmler,  Tristan Krassnig,  Anita Brugger &  Armand Hausmann

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  1. Thomas Post MD
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  2. Georg Kemmler
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  3. Tristan Krassnig
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Correspondence to Thomas Post MD.

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Post, T., Kemmler, G., Krassnig, T. et al. Wirksamkeit einer EKT-Erhaltungstherapie (EEKT) bei Patienten mit therapieresistenten affektiven Störungen – Ergebnisse einer retrospektiven Datenanalyse. Neuropsychiatr 29, 133–138 (2015). https://doi.org/10.1007/s40211-015-0150-1

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