https://scholars.lib.ntu.edu.tw/handle/123456789/476377
標題: | Impacts of Electroconvulsive Therapy on 1-Year Outcomes in Patients with Schizophrenia: A Controlled, Population-Based Mirror-Image Study | 作者: | Lin H.-T. Liu S.-K. MING-HSIEN HSIEH YI-LING CHIEN I-MING CHEN Shih-Cheng Liao Tsai H.-J. CHI-SHIN WU |
公開日期: | 2018 | 卷: | 44 | 期: | 4 | 起(迄)頁: | 798-806 | 來源出版物: | Schizophrenia Bulletin | 摘要: | Objectives Despite the decline in the use of electroconvulsive therapy (ECT) in patients with schizophrenia, ECT augmentation is still recommended for those with poor response to standard pharmacological intervention. However, the effectiveness of augmentation of antipsychotics with ECT on long-term clinical outcomes needs to be verified in an expanded sample. Methods Patients who were hospitalized for schizophrenia and received ECT for the first time during that hospitalization were identified from the total population health insurance database in Taiwan between 2002 and 2011. A comparison group was randomly selected and matched by age, gender, calendar year of hospitalization, and duration of hospitalization. Using a mirror-image design, the changes in rates of psychiatric and overall hospitalization, length of hospital stay, number of emergency department visits, and direct medical costs across the 1-year pre-and post-treatment periods were examined. Results A total of 2074 patients with the same number of comparison participants were included in the analysis. The rate of re-hospitalization decreased significantly in the ECT group during the 1-year post-treatment period, while there was no significant difference in the comparison group. Correspondingly, the total medical expenses increased significantly in the non-ECT group, but not in the ECT group. Notably, the reduction in the psychiatric re-hospitalization rate in the ECT group was more pronounced among those treated with clozapine or a medium-high average daily dose of antipsychotics. Conclusion This 1-year mirror-image analysis indicated that augmentation of antipsychotics with ECT in schizophrenic patients was associated with a reduced rate of psychiatric re-hospitalization. ? The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/476377 | DOI: | 10.1093/schbul/sbx136 | SDG/關鍵字: | clozapine; neuroleptic agent; adult; aged; alcoholism; Article; clinical outcome; controlled study; drug dependence; electroconvulsive therapy; emergency ward; epilepsy; female; hospital cost; hospitalization; human; ICD-9-CM; length of stay; long term care; major clinical study; male; middle aged; monotherapy; mood disorder; national health insurance; population health; population research; priority journal; schizophrenia; therapy effect; adolescent; controlled clinical trial; electroconvulsive therapy; multimodality cancer therapy; outcome assessment; schizophrenia; statistics and numerical data; young adult; Adolescent; Adult; Aged; Antipsychotic Agents; Combined Modality Therapy; Electroconvulsive Therapy; Female; Hospitalization; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Schizophrenia; Young Adult |
顯示於: | 醫學系 |
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