100 Hz快速磁抽搐治疗难治性抑郁症共病强迫症1例

100 Hz accelerated magnetic seizure therapy for treatment-resistant depression comorbid obsessive-compulsive disorder:a case report

抑郁症(major depressive disorder,MDD)是致残率最高的疾病之一,临床上约有1/3的MDD患者在连续服用抗抑郁药多个疗程后没有显著改善,最终转变为难治性抑郁症(treatment-resistant depression,TRD)。TRD是一种更为严重、复杂的疾病亚型,临床治疗具有挑战性。强迫症(obsessive-compulsive disorder,OCD)是以反复出现强迫观念和(或)强迫行为为基本特征的一类精神障碍,与其他精神疾病的高共病率已被确定为OCD的标志性特征,其中以MDD共病OCD最为常见,且症状更为严重,自杀发生概率更高。磁抽搐治疗(magnetic seizure therapy,MST)是一种新型非侵入性神经调控技术,可安全有效治疗TRD,且认知损伤更小。本文报道了1例TRD共病OCD的患者在经100 Hz快速MST治疗后症状显著改善的案例。作为一种新的治疗选择,未来仍需要更多的大型临床研究进一步探索。

Major depressive disorder(MDD)is one of the most disabling illnesses,and approximately one-third of patients with MDD fail to show significant improvement after multiple courses of antidepressants,eventually progressing to treatment-resistant depression(TRD),a more severe and complex subtype that is difficult to treat.Obsessive-compulsive disorder(OCD)is a type of mental disorder characterized by repetitive obsessions and/or compulsive behaviors,and the high rate of comorbidity with other psychiatric disorders has been identified as a hallmark feature of OCD.In particular,OCD frequently co-occurs with MDD,and when these two conditions overlap,the resulting comorbidity is characterized by more severe symptoms and an increased risk of suicide.Magnetic seizure therapy(MST)is a novel,non-invasive neuromodulation technique that is safe and effective in the treatment of TRD with less cognitive impairment.This paper describes a case of significant symptom improvement following 100 Hz accelerated MST treatment in a patient with comorbid TRD and OCD.As a novel treatment option,MST requires further large-scale clinical trials to explore in the future.