国际精神病学杂志--大牛智慧平台

• 文章 •

改良电休克治疗（MECT）对严重精神疾病患者认知功能的影响评估

涂卫丰,周勇杰,李毅,蔡璐遥,许乃川,曾慧

* 通信作者：周勇杰， 单位：深圳市康宁医院

摘要

目的：评估改良电休克治疗（MECT）对严重精神障碍患者认知功能的影响。

方法：通过全国多中心的前瞻性研究，于2022年9月至2023年9月，在全国9个省的精神疾病医院中招募从未接受过电休克治疗且符合MECT适应症的成年患者。在MECT治疗前3天以及治疗后第3天，收集患者的一般人口学信息、临床信息和药物使用情况，采用威斯康辛卡片分类测验及Stroop色-词关联测验评估患者的认知功能。

结果：本研究共调查27名严重精神障碍患者。与治疗前比较，MECT治疗后患者威斯康辛卡片分类测验正确应答百分数（RCP）评分明显下降（Z=-1.973，P=0.049）；但Stroop测验评分无统计学差异（P＞0.05）。二元logistic回归模型显示年龄与性别不是认知功能的影响因素（P＞0.05）。

结论：与治疗前相比，MECT治疗对患者在抽象概括能力、认知转移能力等方面有一定影响，但对其他认知能力未发现有显著性改变。

关键词：精神障碍；威斯康辛卡片分类测验；Stroop测验；改良电休克治疗；认知功能

ABSTRACT

Objective: To evaluate the impact of modified electroconvulsive therapy (MECT) on cognitive functions in patients with severe psychiatric disorders.

Methods: Through a nationwide multicenter prospective study, from September 2022 to September 2023, adult patients who had never received electroconvulsive therapy and met the indications for MECT were recruited from mental hospitals in nine provinces across the country. Three days before and three days after MECT treatment, general demographic information, clinical information, and medication use were collected through self-administered questionnaires, and cognitive functions were assessed using the Wisconsin Card Sorting Test and the Stroop Color-Word Association Test.

Results: A total of 27 patients with severe psychiatric disorders were surveyed in this study. Compared with before treatment, the percentage of correct responses (RCP) score significantly decreased after MECT treatment (Z=-1.973,P=0.049); binary logistic regression model showed that age and gender were not influencing factors for the scores of each item in WCST, and there was no significant effect on scores among different age groups and genders (P>0.05); there were no significant statistical differences in the scores and indicators of the Stroop scale three days after treatment (P>0.05), and binary logistic regression model showed that age and gender were not influencing factors for Stroop scores. It can be concluded that compared with before treatment, MECT treatment has a significant impact on patients' abstract summarization ability, cognitive transfer ability, etc., in the short term, but does not have a significant impact on other aspects, and there is no significant change in the ability to suppress cognitive interference when evaluating patients.

Key words: Psychiatric disorders; WCST; Stroop; MECT;Cognitive function

引用本文 / How to Cite This Article

涂卫丰,周勇杰,李毅,蔡璐遥,许乃川,曾慧.改良电休克治疗（MECT）对严重精神疾病患者认知功能的影响评估[J]. 国际精神病学杂志, 2026, 53(1): 139-143

参考文献

[1] 孙鸿逊, 毛云峰, 沈亦明, 等. 无抽搐电休克治疗对精神分裂症患者认知功能的影响 [J] [J]. 中国现代医生 , 2015 , 53 (02 ): 68 -72 .

[2] 李伟, 周卉, 姚苗苗,等. 无抽搐电休克治疗常见不良反应及其发生机制 [J] [J]. 精神医学杂志 , 2016 , 29 (03 ): 238 -40 .

[3] 葛禛禛, 冯枫, 王磊. 认知功能评估的常用量表及临床应用 [J] [J]. 中国卒中杂志 , 2014 , 9 (06 ): 500 -4 .

[4] 钱卫娟, 范俭雄, 周群, 等. 无抽搐电休克治疗对认知功能的影响 [J] [J]. 四川精神卫生 , 2009 , 22 (02 ): 78 -80 .

[5] SUTOR B, RASMUSSEN K G. Clinical Challenges in Maintenance Electroconvulsive Therapy for Older Patients With Medical Comorbidity [J] [J]. The journal of ECT , 2016 , 32 (1 ): 67 -9 .

[6] LAW K C, KHAZEM L R, JIN H M, et al. Non-suicidal self-injury and frequency of suicide attempts: The role of pain persistence [J] [J]. Journal of affective disorders , 2017 , 209 ( ): 254 -61 .

[7] 廖志贤, 姚湘林, 韦宗赛, 等. 2018年来宾市登记在册的严重精神障碍疾病患者现状分析 [J] [J]. 社区医学杂志 , 2020 , 18 (15 ): 1051 -4 .

[8] 刘紫珊, 马亚荣, 张杰, et al. 单相与双相抑郁障碍患者临床特征的对照研究 [J] [J]. 四川精神卫生 , 2018 , 31 (04 ): 335 -8 .

[9] 陈翔春, 王雅萍, 江文庆, 等. MECT治疗精神障碍的不良反应及相关因素分析 [J] [J]. 上海医药 , 2016 , 37 (05 ): 53 -5+9 .

[10] 范桂红, 何俊, 庞高峰, et al. 无抽搐电休克疗法对精神分裂症患者的治疗效果和脑内及不同脑区神经递质水平的影响研究 [J] [J]. 中国全科医学 , 2022 , 25 (03 ): 325 -30 .

[11] 袁媛, 马一凡, 李向昕. 无抽搐电休克治疗仪联合药物治疗在难治性精神分裂症患者中的应用分析 [J] [J]. 齐齐哈尔医学院学报 , 2024 , 45 (01 ): 45 -8 .

[12] 吴涵, 王雪, 王丹,等. 抑郁发作患者认知功能对自杀行为的影响 [J] [J]. 首都医科大学学报 , 2024 , 45 (01 ): 61 -7 .

[13] ZWIL A S, POMERANTZ A. Transient postictal psychosis associated with a course of ECT [J] [J]. Convulsive therapy , 1997 , 13 (1 ): 32 -6 .

[14] 杨楹. 无抽搐电休克治疗对精神分裂症患者记忆的远期影响 [J] [J]. 精神医学杂志 , 2015 , 28 (04 ): 278 -80 .

[15] 杭荣华, 许亚军, 谢海烽,等. 威斯康星卡片分类测验用于颅脑损伤者认知功能障碍鉴定 [J] [J]. 法医学杂志 , 2011 , 27 (05 ): 346 -9 .

[16] 朱熊兆, 王晓燕, 黄瑛, et al. 不同程度述情障碍者威斯康星卡片分类测验的比较研究 [J] [J]. 中国临床心理学杂志 , 2006 , (02 ): 132 -3+1 .

[17] YOSHII F, ONAKA H, KOHARA S, et al. Early detection of cognitive impairment in Parkinson's disease with the use of the Wisconsin Card Sorting Test: correlations with Montreal Cognitive Assessment and smell identification test [J] [J]. J Neural Transm (Vienna) , 2019 , 126 (11 ): 1447 -54 .

[18] MACLEOD C M. Half a century of research on the Stroop effect: an integrative review [J] [J]. Psychological bulletin , 1991 , 109 (2 ): 163 -203 .

[19] 陈俊, 刘海燕, 张积家. Stroop效应研究的新进展——理论、范式及影响因素 [J] [J]. 心理科学 , 2007 , (02 ): 415 -8+390 .

[20] 刘豫鑫王. 伴与不伴学习困难的注意缺陷多动障碍患儿认知特点的比较 [J] [J]. 中华精神科杂志 , 2002 , (04 ): 31 -4 .

标题作者
文章摘要
参考文献
引用本文
相关文章

PDF 全文下载

浏览量

285

PDF下载量