药物治疗基础上合并电抽搐治疗对精神分裂症患者的记忆和执行功能的影响

The effects of modified electroconvulsive therapy based on drug therapy on memory and executive function in patients with schizophrenia.

目的了解药物是否合并改良电抽搐治疗(modified electroconvulsive therapy,MECT)对精神分裂症患者记忆和执行功能的影响。方法纳入非典型抗精神病药物合并或不合并MECT治疗的精神分裂症患者各30例(分别简称合并MECT组和对照组)。在治疗前和第1次、第6次以及末次MECT治疗的次日(相应简称时点1、2、3),采用韦氏成人记忆测验、威斯康星卡片分类测验(Wisconsin card sorting test,WCST)评估合并MECT组的记忆和执行功能;而对照组在治疗前和治疗后第1、3、6周末(相应简称时点1、2、3)等与合并MECT组相近的评估时点进行同样的评定。比较两组治疗前后及组间的差异。结果治疗前合并MECT组和对照组的记忆商数(memory quo-tient,MQ)分别为(81.3±11.3)和(94.0±14.9),前者明显低于后者(P<0.01),故将基线时MQ作为协变量,两组间3个时点MQ比较的差异均无统计学意义(P>0.50)。治疗前,合并MECT组WCST的完成应答数、错误应答数高于对照组(P>0.01),故将上述2个变量的基线值作为协变量,之后3个时点两组间的差异均无统计学意义(P>0.05)。WCST其他指标在各时点的组间差异均无统计学意义(P>0.05)。结论本研究未发现药物治疗基础上合并MECT治疗损害精神分裂症患者的记忆和执行功能。

Objective To investigate the effects of modified electroconvulsive therapy （MECT） on memory and executive function in schizophrenic. Methods Thirty patients with schizophrenia receiving MECT and atypical antipsychotits were included as combined MECT group and 30 receiving atypical antipsychotics only were served as control group. Wechsler memory scale for adults （WMS） and Wisconsin card sorting test （WCST） were used to evaluate memory and executive function in patients in different time points. General linear model （repeated measures） was conducted to analyze the data. Results The memory quotient（MQ） at baseline was lower in combined MECT group than in control group （81.3 ± 11.3 vs 94. 0 ± 14. 9, respectively, t = 3.84, P 〈 0. 01 ）. There were not differences between two groups at the time point 1, 2 and 3 in the analysis with baseline MQ as a covariale （ F =0.45, P =0. 50）. For WCST, numbers of reply all （ RA）, and reply error （RE） at baseline were higher in combined MECT group than in control group （P 〉 0. 01 ）. There were no differences at RA, RE or RPE between two groups at the three time points in the analysis with baseline MQ as a covariate （ P 〉 0. 05 ）. There were no significant differences at other variances of WCST between two groups at all time points. Conclusions Our data suggest that MECT may not have any negative effect on memory or on executive function in patients with schizophrenia.