Correlative Factors And Efficacy Of Modified Electroconvulsive Therapy In Schizophrenia

Objective:To observe the clinical characteristics and effects of modified electroconvulsive therapy(MECT)for schizophrenic patients.To discuss the correlation between clinical effects and the treatment of MECT for schizophrenic patients.In order to provide the practical basis for the clinical therapy schedule for MECT.Methods:A retrospective study was conducted on 355 schizophrenic patients treated with MECT from January 2015 to December 2017 in Wuxi Mental Health Center.The sociological information of patients includes age,gender,educational level,course of illness,first onset,drug dosage,body mass index(BMI),smoking history,drinking history,family history and treatment times.The therapy schedule of MECT including energy percentage,static resistance,dynamic resistance,effective convulsion time,convulsion index,inhibition index,stimulus electric quantity,stimulus electric current,discharge time,inhibition frequency and the Positive and Negative Symptoms Scale Score.The PANSS score reduction rate was used as the criterion for evaluating the efficacy of patients,the patients with clinical recovery(>75%)and significant effectiveness(50%-74%)were classified as effective group,and the others(<50%)as ineffective group.The differences of all the factors between the effective group and the ineffective group were analyzed by Chi-square test and t test.Pearson test and multivariate logistic regression analysis were used to find out the related factors that affect the efficacy of MECT.Results:(1)Compared with the general data of the two groups.The proportion of women in the effective group,education level,and the proportion of the first-episode number were higher than those in the ineffective group,and the difference was statistically significant(P<0.05).The average age of the effective group was lower than that of the ineffective group,and the difference was statistically significant(P<0.05).The number of smokers in the effective group was less than that in the ineffective group(P<0.05).The number of treatment in effective group was more than that in ineffective group and the difference was statistically significant(P<0.05).No significant difference was shown between the effective group and the ineffective group in drug dosage,BMI,proportion of drinkers and family history(P>0.05).(2)Comparison of two groups' disease characteristics.?There was no significant difference in PANSS positive factor score and general psychopathological factor score between the effective group and the ineffective group before treatment(P>0.05).The total PANSS score,PANSS negative factor score and PANSS excitatory factor score of the effective group patients before treatment were higher than those of the ineffective group ones,and the difference was statistically significant(P<0.05).?There was no significant difference in the reduction rate of PANSS positive factor score between the effective group and the ineffective group before and after the treatment(P>0.05).The total score reduction of PANSS,the negative factor score reduction of PANSS,the general psychopathological factor score reduction of PANSS and the excitatory factor score reduction of PANSS in the effective group were higher than those in the ineffective group before and after treatment,and the difference was statistically significant(P<0.05).?Clinical characteristics analysis showed that the proportion of patients with delusions,critical hallucinations and command hallucinations in the effective group was lower than that in the ineffective group,and the difference was statistically significant(P<0.05).The proportion of patients with tension and negative symptoms in the effective group was higher than that in the ineffective group(P<0.05).There was no significant difference in the other mental symptoms between the effective group and the invalid group(P>0.05).(3)MECT parameters of the two groups were compared,the effective convulsion time in effective group was longer than that in ineffective group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups in terms of convulsion index,inhibition index,static resistance,dynamic resistance,energy percentage,stimulation quantity,stimulation current,discharge time and stimulation frequency(P>0.05).(4)Pearson correlation analysis showed that age,courses of disease and BMI were negatively correlated with the efficacy of MECT,while negative factor score,PANSS excitatory factor score,total PANSS score,treatment times and effective convulsion time were positively correlated with the efficacy of MECT.(5)Logistic regression analysis showed that age,course of disease,first episode,degree of negative symptoms before treatment,degree of excitement and aggression symptoms before treatment,and effective convulsion time were the correlation factors of MECT in the treatment of schizophrenia(P<0.05).Conclusion:(1)Older age and longer course of the disease are the negative factors affecting the efficacy of MECT.The efficacy of MECT in such patients may not be satisfactory and should be carefully selected.(2)The first onset,negative symptoms before treatment,excitement and aggression symptoms are obviously positive factors affecting the efficacy of MECT.Therefore,clinically patients with schizophrenia of this kind can be controlled by MECT as soon as possible to shorten the length of hospitalization.(3)Effective convulsive time is also an important factor affecting the efficacy of MECT.Optimised control of effective convulsive time is the key to the success of MECT.